Issue Number 412            September 17, 2003

CONTENTS OF THIS ISSUE

1. CDC issues instructions for protecting vaccine in the event of weather catastrophes

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September 17, 2003
CDC ISSUES INSTRUCTIONS FOR PROTECTING VACCINE IN THE EVENT OF WEATHER CATASTROPHES

On September 17, the Centers for Disease Control and Prevention (CDC) issued an urgent message to its grant recipients about safeguarding vaccines during weather catastrophes. With the CDC's  approval, we are sharing its content with our readers. Please note: Though this message is focused on Hurricane Isabel, the instructions pertain to safeguarding vaccines in other weather catastrophes as well. The message is reprinted below.

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September 17, 2003
IMPORTANT IMMUNIZATION INFORMATION: READ IMMEDIATELY

Hurricane Isabel is expected to make landfall along the Mid-Atlantic Coast later this week. To protect vaccine in storage and to minimize the potential monetary loss from the hurricane, projects should immediately begin to implement emergency procedures at both the depot and provider level. A part of this implementation should include communiqués to all providers who receive public purchased vaccines, or at least to those in the geographic areas of highest risk.

When the state, local officials, or provider has reasonable cause to believe that weather conditions have the potential to disrupt power and/or flood any office where vaccine is stored, emergency procedures should be implemented IN ADVANCE OF THE EVENT.

In advance of the emergency, all providers should ensure the following:

1. identification of an alternative storage facility (hospital, packing plant, state depot, etc.), with back-up power (generator), where the vaccine can be properly stored and monitored for the duration of the storm,
    
2. the availability of staff to pack and move the vaccine,
    
3. the use of appropriate packing containers, cold packs, and dry ice (for varicella vaccine), and
    
4. the transport of the vaccine to the secure storage facility.

It is appropriate for providers to suspend vaccinations before weather conditions deteriorate. Sufficient time must be allowed for packing and transporting vaccine BEFORE the storm can adversely affect local conditions.

There are other precautions and appropriate measures one can take to protect vaccine inventories using the emergency procedures described below. The following includes some HELPFUL HINTS AND REFERENCE INFORMATION.

I. EMERGENCY PROCEDURES

1. List emergency phone numbers, companies, and points of contact for:

1. Electrical power company:
2. Refrigeration repair company:
3. Temperature alarm monitoring company:
4. Perimeter alarm repair company:
5. Perimeter alarm monitoring company:
6. Backup storage facility:
7. Transportation to backup storage:
8. Dry ice vendor:
9. Emergency generator repair company:
10. National weather service:
11. Manufacturers:

1. Merck Sharpe & Dohme: 800-672-6372
2. Aventis Pasteur: 800-VACCINE (800-822-2463)
3. GlaxoSmithKline: 800-366-8900
4. Wyeth Lederle Labs: 800-666-7248

["IAC EXPRESS" Editor's Note: The telephone numbers originally supplied for Merck Sharpe & Dohme and Wyeth Lederle Labs are no longer active; the updated numbers that appear here were active as of 9/17/03.]

2. State/project assistance to providers in possession of vaccine

1. Identify hospitals, health departments or other facilities that could serve as emergency vaccine storage facilities and communicate this information. This might also be done at the regional or county level and/or with the assistance of Bioterrorism or Emergency Preparedness Units.
2. Prioritize assistance and communication to target providers in areas at highest risk, e.g., low lying coastal or floodplain areas.

3. Entering vaccine spaces: Describe, when necessary, how to enter the building and vaccine storage spaces in an emergency if closed or after hours. Include a floor diagram and the locations of:

1. Doors
2. Flash lights
3. Spare batteries
4. Light switches
5. Keys
6. Locks
7. Alarms
8. Circuit breakers
9. Packing materials

4. Identify whom to call for the following items:

1. Equipment problems
2. Backup storage
3. Backup transportation
4. Security

5. Identify what vaccines to pack first in an emergency and while the power is still working:

1. Pack the refrigerated vaccines first with an adequate supply of cold packs.
2. Remove and pack the varicella vaccine, using dry ice, immediately before it is to be transported.

6. Pack and transport all vaccine or if that is not possible, determine the types and amounts to save: e.g., save only the most expensive vaccines to minimize dollar loss or save some portion of all vaccines to ensure a short-term, complete supply for resuming the vaccination schedule. We would suggest the first priority be given to those vaccines which would be the most expensive to replace.
    
7. Follow vaccine packing procedures for transport to backup storage facilities:

1. Open refrigerated units only when absolutely necessary and only after you have made all preparations for packing and moving the vaccine to alternative storage sites.
2. Use properly insulated containers.

8. Move vaccine to backup storage according to pre-arranged plans.

1. How to load transportation vehicle
2. Routes to take
3. Time enroute

NOTE: The two National Oceanic and Atmospheric Administration sites below are providing up-to-date information on Hurricane Isabel:

1. http://www.srh.noaa.gov/tlh/tropical
2. http://www.nhc.noaa.gov

Satellite tracking of significant weather is also available at http://www.goes.noaa.gov