Temperature Log for Refrigerator and Freezer — Fahrenheit
Month/Year:
Days 1–15
Complete 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 and at least three days each
week. 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. Record the temperatures in I-CARE
at least once a week. Once the month has ended, save each month’s completed form for 3 years, unless state or local jurisdictions require a longer time period.
A recorded temperature in the shaded zone represents an unacceptable temperature range. Follow these steps:
1.
Store the vaccine under proper conditions as quickly as possible.
3.
Complete the Vaccine Incident Report to determine whether the vaccine is still usable.
2.
Temporarily mark exposed vaccine “do not use” until you have verified whether or not
4.
Document the action taken on the reverse side of this log.
the vaccine may be used.
Day of
Month
Staff
Initials
Room
Temp
Exact
Time
F Temp
1
am
REFRIGERATOR
≥49
48
47
2
pm
am
3
pm
am
TOO WARM
4
pm
am
5
pm
am
6
pm
am
7
pm
am
8
pm
am
9
pm
am
10
pm
am
11
pm
am
12
pm
am
13
pm
am
Take immediate corrective action if temperature is in shaded section.
14
pm
am
15
pm
am
pm
TOO WARM
46
45
44
43
42
41
40
39
38
37
36
35
34
33
≤32
TOO COLD
Take immediate corrective action if temperature is in shaded section.
TOO COLD
NOTE: Aim for a refrigerator temperature of 40 F.
FREEZER
F Temp
≥-8
7
6
am
pm
am
pm
am
TOO WARM
pm
am
pm
am
pm
am
pm
am
pm
am
pm
am
pm
am
pm
am
pm
am
pm
Take immediate corrective action if temperature is in shaded section.
am
pm
am
pm
am
pm
TOO WARM
5
4
≤3
NOTE: Some frozen vaccines must not be stored colder than –58 F. Check the prescribing information on the vaccine manufacturer’s website for specific storage temperature instructions.
VACCINE STORAGE TROUBLESHOOTING RECORD
Use this page to record the details of the vaccine storage incident, including when the incident was reported to the state and the results of the incident (such as vaccine was viable or still usable or
the vaccine had to be wasted). The vaccine incident report must be completed and a copy kept in your records. The vaccine incident report is in I-CARE under reports, VFC warehouse forms.
DATE OF INCIDENT
REPORTED BY
DATE REPORTED TO IDPH
TEMPERATURE EXCURSION
RESULTS OF INCIDENT
(Vaccine viable, vaccine wasted, unit repaired or replaced)
Temperature Log for Refrigerator and Freezer — Fahrenheit
Month/Year:
Days 16-31
Complete 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 and at least three days each
week. 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. Record the temperatures in I-CARE
at least once a week. Once the month has ended, save each month’s completed form for three years, unless state or local jurisdictions require a longer time period.
A recorded temperature in the shaded zone represents an unacceptable temperature range. Follow these steps:
1.
Store the vaccine under proper conditions as quickly as possible.
3.
Complete the Vaccine Incident Report to determine whether the vaccine is still usable.
2.
Temporarily mark exposed vaccine “do not use” until you have verified whether or not
4.
Document the action taken on the reverse side of this log.
the vaccine may be used.
Day of
Month
Staff
Initials
Room
Temp
Exact
Time
F Temp
16
am
REFRIGERATOR
≥49
48
47
17
pm
am
18
pm
am
19
pm
TOO WARM
am
20
pm
am
21
pm
am
22
pm
am
23
pm
am
24
pm
am
25
pm
am
26
pm
am
27
pm
am
28
pm
am
29
pm
am
Take immediate corrective action if temperature is in shaded section
30
pm
am
31
pm
am
pm
TOO WARM
46
45
44
43
42
41
40
39
38
37
36
35
34
33
≤32
TOO COLD
Take immediate corrective action if temperature is in shaded section
TOO COLD
NOTE: Aim for a refrigerator temperature of 40 F.
F 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
FREEZER
≥8
7
TOO WARM
Take immediate corrective action if temperature is in shaded section
TOO WARM
6
5
4
≤3
NOTE: Some frozen vaccines must not be stored colder than -58 F. Check the prescribing information on the vaccine manufacturer’s website for specific storage temperature instructions.
pm
VACCINE STORAGE TROUBLESHOOTING RECORD
Use this page to record the details of the vaccine storage incident, including when the incident was reported to the state and the results of the incident (such as vaccine was viable or still usable or
the vaccine had to be wasted). The vaccine incident report must be completed and a copy kept in your records. The vaccine incident report is in I-CARE under reports, VFC warehouse forms.
DATE OF INCIDENT
REPORTED BY
DATE REPORTED TO IDPH
TEMPERATURE EXCURSION
RESULTS OF INCIDENT
(Vaccine viable, vaccine wasted, unit repaired or replaced)