Temperature Log for Vaccines (Fahrenheit) Completing this temperature log: Check the temperatures in both the freezer and the refrigerator compartments of your vaccine storage units at least twice each working day. Place an “X” in the box that corresponds with the temperature and record the ambient (room) temperature, the time of the temperature readings, and your initials. Once the month has ended, save each month’s completed form for 3 years, unless state or local jurisdictions require a longer time period. If the recorded temperature is in the shaded zone: This represents an unacceptable temperature range. Follow these steps: 1. Store the vaccine under proper conditions as quickly as possible. 2. Call the vaccine manufacturer(s) to determine whether the potency of the vaccine(s) has been affected. 3. Call the immunization program at your local health department for further assistance: (_____) _________________. 4. Document the action taken on the reverse side of this log. Month/Year:______________ Days 1–15 Day of Month: Staff Initials: Room Temp.: Exact Time: 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 oF Temp am pm am pm am pm am pm am pm am pm am pm am pm am pm am pm am pm am pm am pm am pm am pm Too Warm*: *49o *48o *47o Refrigerator Temperature: Aim for 40o 46o 45o 44o 43o 42o 41o 40o 39o 38o 37o 36o 35o Too Cold*: *34o *33o *32o Freezer Temperature: Too Warm*: *8o *7o *6o 5o 4o 3o IMPORTANT: * Too warm or too cold. Take immediate action if temperature has a *. Vaccine Storage Troubleshooting Record: Date: Time: Storage Unit Temp: Room Temp: Problem: Action Taken: Results: Initials: Temperature Log for Vaccines (Fahrenheit) Completing this temperature log: Check the temperatures in both the freezer and the refrigerator compartments of your vaccine storage units at least twice each working day. Place an “X” in the box that corresponds with the temperature and record the ambient (room) temperature, the time of the temperature readings, and your initials. Once the month has ended, save each month’s completed form for 3 years, unless state or local jurisdictions require a longer time period. If the recorded temperature is in the shaded zone: This represents an unacceptable temperature range. Follow these steps: 1. Store the vaccine under proper conditions as quickly as possible. 2. Call the vaccine manufacturer(s) to determine whether the potency of the vaccine(s) has been affected. 3. Call the immunization program at your local health department for further assistance: (_____) _________________. 4. Document the action taken on the reverse side of this log. Month/Year:______________ Days 16–31 Day of Month: Staff Initials: Room Temp.: Exact Time: 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 oF Temp am pm am pm am pm am pm am pm am pm am pm am pm am pm am pm am pm am pm am pm am pm am pm am pm Too Warm*: *49o *48o *47o Refrigerator Temperature: Aim for 40o 46o 45o 44o 43o 42o 41o 40o 39o 38o 37o 36o 35o Too Cold*: *34o *33o *32o Freezer Temperature: Too Warm*: *8o *7o *6o 5o 4o 3o IMPORTANT: * Too warm or too cold. Take immediate action if temperature has a *. Vaccine Storage Troubleshooting Record: Date: Time: Storage Unit Temp: Room Temp: Problem: Action Taken: Results: Initials: Adapted by the Immunization Action Coalition courtesy of the Michigan Department of Community Health and the California Department of Health Services. Distributed by the Immunization Action Coalition • (651) 647-9009 • www.immunize.org • www.vaccineinformation.org • admin@immunize.org www.immunize.org/catg.d/p3039.pdf • Item #P3039 (1/07) Technical content reviewed by the Centers for Disease Control and Prevention, Jan. 2007.