Refrigerator Temperature Log PDF Details

The Refrigerator Temperature Log form is a crucial tool designed to monitor and document temperatures within refrigeration units, specifically for the safe storage of vaccines, including COVID-19 vaccines. Integral to maintaining vaccine efficacy, this log aids in ensuring temperatures are kept within the recommended ranges, articulated clearly as not exceeding 46ºF (too warm) and not dropping below 36ºF (too cold). With sections dedicated to logging daily temperatures for the first half and the latter half of the month, the significance of accuracy and consistent monitoring is emphasized through required staff initials and exact time recordings. Additionally, this form encompasses guidelines on actions to be taken in the event of temperature deviations, including immediate steps for vaccine preservation and detailed reporting via the Vaccine Storage Troubeingooting Record. By mandating the documentation of corrective actions and the maintenance of these records for at least three years (or longer if state regulations dictate), it reinforces the responsibility of healthcare facilities in vaccine caretaking. Adapted from resources by the California Department of Public Health and distributed by the Immunization Action Coalition, this form not only serves as a record-keeping device but also as a compliance instrument to state and local health standards, offering a methodological approach to vaccine storage management.

QuestionAnswer
Form NameRefrigerator Temperature Log
Form Length5 pages
Fillable?No
Fillable fields0
Avg. time to fill out1 min 15 sec
Other nameszer refrigerator temperature log, refrigerator temperature log monthly nc, refrigerator zer temperature log, refrigerator log

Form Preview Example

F°

Temperature Log for Refrigerator – Fahrenheit

DAYS 1–15

For information on storage and handling of COVID-19 vaccines, see the COVID-19 Vaccine Addendum in CDC’s updated Vaccine Storage and Handling Toolkit at www.cdc.gov/vaccines/hcp/admin/storage/toolkit/index.html.

Monitor temperatures closely!

temps, document current temps twice, at

Month/Year

 

VFC PIN or other ID #

 

Page 1 of 2

 

 

 

1.Write your initials below in “Staff Initials,” and note the time in “Exact Time.”

2.If using a temperature monitoring device

(TMD; digital data logger recommended) that records min/max temps (i.e., the highest and lowest temps recorded in a specific time period), document current and min/max once each workday, preferably in the morning. If using TMD that does not record min/max

beginning and end of each workday.

3.Put an “X” in the row that corresponds to the refrigerator’s temperature.

4.If any out-of-range temp observed, see instructions to the right.

5.After each month has ended, save each month’s log for 3 years, unless state/local jurisdictions require a longer period.

Facility Name

Take action if temp is out of range – too warm (above 46ºF) or too cold (below 36ºF).

1.Label exposed vaccine “do not use,” and store it under proper conditions as quickly as possible. Do not discard vaccines unless directed to by your state/local health department and/or the manufacturer(s).

2.Record the out-of-range temps and the room temp in the “Action” area on the bottom of the log.

3.Notify your vaccine coordinator, or call the immunization program at your state or local health department for guidance.

4.Document the action taken on the attached

“Vaccine Storage Troubleshooting Record.”

Day of Month

1

 

2

 

3

 

4

 

5

 

6

 

7

 

8

 

9

 

10

 

11

 

12

 

13

 

14

 

15

Staff Initials

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

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

Exact Time

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Min/Max Temp in Unit

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(since previous reading)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Danger! Temperatures above 46ºF are too warm! Write any out-of-range temps and room temp on the lines below and call your state or local health department immediately!

temperatures

Aim for 41º

acceptable

46˚F

45˚F

44˚F

43˚F

42˚F

41˚F

40˚F

39˚F

38˚F

37˚F

36˚F

Danger! Temperatures below 36ºF are too cold! Write any out-of-range temps and room temp on the lines below and call your state or local health department immediately!

action

Write any out-of-range temps (above 46ºF or below 36ºF) here:

Room Temperature

If you have a vaccine storage issue, contact your state or local health department for guidance and complete the attached “Vaccine Storage Troubleshooting Record.”

DISTRIBUTED BY THE

IMMUNIZATION ACTION COALITION Saint Paul, Minnesota 651-647-9009 www.immunize.org www.vaccineinformation.org

Adapted with appreciation from California Department of Public Health

www.immunize.org/catg.d/p3037F.pdf Item #P3037F (8/21)

F°

Temperature Log for Refrigerator – Fahrenheit

DAYS 16 –31

For information on storage and handling of COVID-19 vaccines, see the COVID-19 Vaccine Addendum in CDC’s updated Vaccine Storage and Handling Toolkit at www.cdc.gov/vaccines/hcp/admin/storage/toolkit/index.html.

Monitor temperatures closely!

temps, document current temps twice, at

Month/Year

 

VFC PIN or other ID #

 

Page 2 of 2

1.Write your initials below in “Staff Initials,” and note the time in “Exact Time.”

2.If using a temperature monitoring device

(TMD; digital data logger recommended) that records min/max temps (i.e., the highest and lowest temps recorded in a specific time period), document current and min/max once each workday, preferably in the morning. If using TMD that does not record min/max

beginning and end of each workday.

3.Put an “X” in the row that corresponds to the refrigerator’s temperature.

4.If any out-of-range temp observed, see instructions to the right.

5.After each month has ended, save each month’s log for 3 years, unless state/local jurisdictions require a longer period.

Facility Name

Take action if temp is out of range – too warm (above 46ºF) or too cold (below 36ºF).

1.Label exposed vaccine “do not use,” and store it under proper conditions as quickly as possible. Do not discard vaccines unless directed to by your state/local health department and/or the manufacturer(s).

2.Record the out-of-range temps and the room temp in the “Action” area on the bottom of the log.

3.Notify your vaccine coordinator, or call the immunization program at your state or local health department for guidance.

4.Document the action taken on the attached

“Vaccine Storage Troubleshooting Record.”

Day of Month

16

 

17

 

18

 

19

 

20

 

21

 

22

 

23

 

24

 

25

 

26

 

27

 

28

 

29

 

30

 

31

Staff Initials

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

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

Exact Time

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Min/Max Temp in Unit

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(since previous reading)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Danger! Temperatures above 46ºF are too warm! Write any out-of-range temps and room temp on the lines below and call your state or local health department immediately!

temperatures

Aim for 41º

acceptable

46˚F

45˚F

44˚F

43˚F

42˚F

41˚F

40˚F

39˚F

38˚F

37˚F

36˚F

Danger! Temperatures below 36ºF are too cold! Write any out-of-range temps and room temp on the lines below and call your state or local health department immediately!

action

Write any out-of-range temps (above 46ºF or below 36ºF) here:

Room Temperature

If you have a vaccine storage issue, contact your state or local health department for guidance and complete the attached “Vaccine Storage Troubleshooting Record.”

DISTRIBUTED BY THE

IMMUNIZATION ACTION COALITION Saint Paul, Minnesota 651-647-9009 www.immunize.org www.vaccineinformation.org

Adapted with appreciation from California Department of Public Health

www.immunize.org/catg.d/p3037F.pdf Item #P3037F (8/21)

Vaccine Storage Troubleshooting Record

(check one) □Refrigerator □Freezer □Ultra-Cold Freezer

Use this form to document any unacceptable vaccine storage event, such as exposure of refrigerated vaccines to temperatures that are outside the manufacturers’ recommended storage ranges.

A fillable pdf of this form is available at www.immunize. org/catg.d/p3041.pdf

Date & Time of Event

Storage Unit Temperature

Room Temperature

Person Completing Report

 

If multiple, related events occurred,

at the time the problem was discovered

at the time the problem was discovered

 

 

see Description of Event below.

 

 

 

 

 

 

 

 

 

 

 

Date:

Temp when discovered:

 

Temp when discovered:

Name:

 

 

 

 

 

 

 

Time:

Minimum temp:

Maximum temp:

Comment (optional):

Title:

Date:

 

 

 

 

 

 

Description of Event (If multiple, related events occurred, list each date, time, and length of time out of storage.)

General description (i.e., what happened?)

Estimated length of time between event and last documented reading of storage temperature in acceptable range (2o to 8oC [36o to 46oF] for refrigerator; -50o to -15oC [-58º to 5ºF] for freezer; -80o to -60oC [-112º to -76ºF] for ultra-cold freezer (may be used for Pfizer COVID-19 vaccine).

• Inventory of affected vaccines, including (1) lot #s and (2) whether purchased with public (for example, VFC) or private funds (Use separate sheet if needed, but maintain the inventory with this troubleshooting record.)

At the time of the event, what else was in the storage unit? For example, were there water bottles in the refrigerator and/or frozen coolant packs in the freezer?

Prior to this event, have there been any storage problems with this unit and/or with the affected vaccine?

Include any other information you feel might be relevant to understanding the event.

Action Taken (Document thoroughly. This information is critical to determining whether the vaccine might still be viable!)

When were the affected vaccines placed in proper storage conditions? (Note: Do not discard the vaccine. Store exposed vaccine in proper conditions and label it “do not use” until after you can discuss with your state/ local health department and/or the manufacturer[s].)

Who was contacted regarding the incident? (For example, supervisor, state/local health department, manufacturer—list all.)

IMPORTANT: What did you do to prevent a similar problem from occurring in the future?

Results

• What happened to the vaccine? Was it able to be used? If not, was it returned to the distributor? (Note: For public-purchase vaccine, follow your state/local health department instructions for vaccine disposition.)

DISTRIBUTED BY THE

IMMUNIZATION ACTION COALITION Saint Paul, Minnesota 651-647-9009 www.immunize.org www.vaccineinformation.org

www.immunize.org/catg.d/p3041.pdf • Item #P3041 (8/21)

Vaccine Storage Troubleshooting Record (check one)

Refrigerator

Freezer

Ultra-Cold Freezer

Use this form to document any unacceptable vaccine storage event, such as exposure of refrigerated vaccines to temperatures that are outside the manufacturers' recommended storage ranges.

Date & Time of Event

Storage Unit Temperature

Room Temperature

Person Completing Report

 

If multiple, related events occurred,

at the time the problem was discovered

at the time the problem was discovered

 

 

see Description of Event below.

 

 

 

 

 

 

 

 

 

 

 

Date: (see below)

Temp when discovered:

45º F

Temp when discovered: 77º F

Name: Natalie Nurse

 

 

 

 

 

 

 

Time: (see below)

Minimum temp: 38º F

Maximum temp: 53º F

Comment (optional):temp is approx.

Title: VFC Coordinator

Date: 6/29/21

Description of Event (If multiple, related events occurred, list each date, time, and length of time out of storage.)

General description (i.e., what happened?)

Estimated length of time between event and last documented reading of storage temperature in acceptable range (2o to 8oC [36o to 46oF] for refrigerator; -50o to -15oC [-58º to 5ºF] for freezer; -80o to -60oC [-112º to -76ºF] for ultra-cold freezer (Pfizer COVID-19 vaccine only)

• Inventory of affected vaccines, including (1) lot #s and (2) whether purchased with public (for example, VFC) or private funds (Use separate sheet if needed, but maintain the inventory with this troubleshooting record.)

At the time of the event, what else was in the storage unit? For example, were there water bottles in the refrigerator and/or frozen coolant packs in the freezer?

Prior to this event, have there been any storage problems with this unit and/or with the affected vaccine?

Include any other information you feel might be relevant to understanding the event.

At 8 am on Tuesday (6/29/21) morning when clinic opened, identified 4 temperature excursions over the weekend in refrigerator with readings as high as 54°, 50°, 49° & 53°F in primary vaccine storage unit #1. Recordings taken every 15 min on calibrated digital data logger overnight. Data logger probe in glycol located in middle of refrigerator with vaccines.

Total time out of range: approximately 3 hrs — maximum temp 53°F (see attached document of continuous temp readings)

Inventory of vaccines: see attached

Water bottles in refrigerator door. No vaccine stored in freezer. No problems with storage unit prior to Saturday night. Thunderstorms in area over weekend may have affected power.

Action Taken (Document thoroughly. This information is critical to determining whether the vaccine might still be viable!)

When were the affected vaccines placed in proper storage conditions? (Note: Do not discard the vaccine. Store exposed vaccine in proper conditions and label it “do not use” until after you can discuss with your state/ local health department and/or the manufacturer[s].)

Who was contacted regarding the incident? (For example, supervisor, state/local health department, manufacturer—list all.)

IMPORTANT: What did you do to prevent a similar problem from occurring in the future?

Vaccines currently stored appropriately at 41ºF. Refrigerator and vaccines labeled "Do Not Use."

My State Immunization Program contacted at 8:30 am. Spoke with Victor Vaccine. Provided Victor with details of event and list of vaccines. Vaccine to remain quarantined until we hear back from Victor.

Called electric company and confirmed 2 short power outages during weekend. Checked refrigerator seals  called refrigerator maintenance company to replace seals.

Checked plug on unit  placed tape over plug to prevent inadvertent dislodging. Plan to purchase plug guard.

Plan to follow up with Immunization Program on data loggers with alarms that could be sent to coordinator and back-up phones.

Results

• What happened to the vaccine? Was it able to be used? If not, was it returned to the distributor? (Note: For public-purchase vaccine, follow your state/local health department instructions for vaccine disposition.)

Late on Monday, I talked with Victor regarding continued use of vaccine. Victor had checked with manufacturers which confirmed that vaccine is acceptable for use. He told me that vaccine could therefore be removed from quarantine. I discussed the entire situation with Susie Supervisor and Dr. Director (clinic medical director) who agreed that we could put vaccine back in use.

DISTRIBUTED BY THE

IMMUNIZATION ACTION COALITION Saint Paul, Minnesota 651-647-9009 www.immunize.org www.vaccineinformation.org

www.immunize.org/catg.d/p3041.pdf • Item #P3041 (8/21)

Vaccine Storage Troubleshooting Record (check one)

Refrigerator

Freezer

Ultra-Cold Freezer

Use this form to document any unacceptable vaccine storage event, such as exposure of refrigerated vaccines to temperatures that are outside the manufacturers' recommended storage ranges.

Date & Time of Event

Storage Unit Temperature

Room Temperature

Person Completing Report

 

If multiple, related events occurred,

at the time the problem was discovered

at the time the problem was discovered

 

 

see Description of Event below.

 

 

 

 

 

 

 

 

 

 

 

Date:7/13/2021

Temp when discovered:

28º F

Temp when discovered: 77º F

Name: Natalie Nurse

 

 

 

 

 

 

 

Time: 8:00 am

Minimum temp: 28º F

Maximum temp: 42º F

Comment (optional):temp is approx.

Title: VFC Coordinator

Date: 7/13/21

Description of Event (If multiple, related events occurred, list each date, time, and length of time out of storage.)

General description (i.e., what happened?)

Estimated length of time between event and last documented reading of storage temperature in acceptable range (2o to 8oC [36o to 46oF] for refrigerator; -50o to -15oC [-58º to 5ºF] for freezer; -80o to -60oC [-112º to -76ºF] for ultra-cold freezer (Pfizer COVID-19 vaccine only)

• Inventory of affected vaccines, including (1) lot #s and (2) whether purchased with public (for example, VFC) or private funds (Use separate sheet if needed, but maintain the inventory with this troubleshooting record.)

At the time of the event, what else was in the storage unit? For example, were there water bottles in the refrigerator and/or frozen coolant packs in the freezer?

Prior to this event, have there been any storage problems with this unit and/or with the affected vaccine?

Include any other information you feel might be relevant to understanding the event.

When checked main clinic fridge (in lab) at 8:00 am on Tuesday, 7/13/2021, digital readout on data logger read 28ºF. Data logger located in center of fridge with probe in glycol . Review of computer readings (taken every 15 minutes) showed steady drop in temps from 42ºF at 8:15 pm (7/12/2021) to 28ºF reading discovered when arrived at clinic on Tuesday morning (7/13/2021). Readings hit 34ºF at 11 pm (7/12) and 32ºF at 2 am (7/13). Total time out of recommended storage temps = 9 hours, with 6 hours at freezing or below (see attached document of continuous temp readings). Inventory of vaccines attached.

Water bottles in refrigerator door and crisper area. No vaccines stored in freezer. No recent adjustments to temp controls and no previous temp excursions noted with this refrigerator before 7/13.

Action Taken (Document thoroughly. This information is critical to determining whether the vaccine might still be viable!)

When were the affected vaccines placed in proper storage conditions? (Note: Do not discard the vaccine. Store exposed vaccine in proper conditions and label it “do not use” until after you can discuss with your state/ local health department and/or the manufacturer[s].)

Who was contacted regarding the incident? (For example, supervisor, state/local health department, manufacturer—list all.)

IMPORTANT: What did you do to prevent a similar problem from occurring in the future?

Upon discovery, vaccines marked “Do Not Use” and stored in 2nd clinic fridge (in exam room #3 at 41ºF). Also placed “Do Not Use” note on main fridge in lab. Notified Susie Supervisor about the issue. Contacted Victor Vaccine at My State Immunization Program at 8:30 am. Provided Victor with details of event and list of vaccines in fridge. Victor said to maintain vaccines in 2nd fridge and that he would check with manufacturers to determine next steps.

Called Jim’s Appliance Repair to examine fridge. Repairman found and replaced faulty thermostat in unit. Reset data logger on center shelf in fridge with probe in glycol .

Results

• What happened to the vaccine? Was it able to be used? If not, was it returned to the distributor? (Note: For public-purchase vaccine, follow your state/local health department instructions for vaccine disposition.)

After fridge thermostat repaired, monitored temps in empty fridge for 1 week, per state requirements. Fridge maintained 39º-41ºF temps for entire week. Submitted repair documentation and data logger readings to Victor Vaccine for approval and ordered replacement vaccines. Victor had checked with manufacturers who confirmed that all vaccines in fridge EXCEPT MMR were no longer viable and should be returned per state policy guidelines. MMR may be used because pkg insert allows storage down to -58ºF. Discussed entire situation with Susie Supervisor and clinic director, Dr. Director, who agreed on continued use of MMR . Will continue to monitor fridge closely to watch for pattern of temp fluctuations indicating potential problem with thermostat. If problems, contact Victor Vaccine for advice on purchasing new fridge meeting criteria for appropriate vaccine storage.

DISTRIBUTED BY THE

IMMUNIZATION ACTION COALITION Saint Paul, Minnesota 651-647-9009 www.immunize.org www.vaccineinformation.org

www.immunize.org/catg.d/p3041.pdf • Item #P3041 (8/21)

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Note the details in s e r u t a r e p m e t, Aim for º, e l b a t p e c c a, F F F F F F F F F F F, Danger Temperatures below ºF are, n o, i t c a, Write any outofrange temps above, Room Temperature, If you have a vaccine storage, distributed by the Immunization, Adapted with appreciation from, and wwwimmunizeorgcatgdpFpdf Item PF.

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The application will require you to provide specific valuable information to automatically fill in the area Temperature Log for Refrigerator, Monitor temperatures closely, and note the time in Exact Time, If using a temperature monitoring, temps document current temps twice, Put an X in the row that, the refrigerators temperature, If any outofrange temp observed, instructions to the right, After each month has ended save, months log for years unless, For information on storage and, MonthYear VFC PIN or other ID, Page of, and Facility Name.

Entering details in refrigerator zer temperature log step 3

You should identify the rights and obligations of each party in field s e r u t a r e p m e t, Aim for º, e l b a t p e c c a, F F F F F F F F F F F, Danger Temperatures below ºF are, n o, i t c a, Write any outofrange temps above, Room Temperature, If you have a vaccine storage, distributed by the Immunization, Adapted with appreciation from, and wwwimmunizeorgcatgdpFpdf Item PF.

Filling in refrigerator zer temperature log step 4

Review the areas Vaccine Storage Troubleshooting, Use this form to document any, A fillable pdf of this form is, Date Time of Event If multiple, Storage Unit Temperature at the, Room Temperature at the time the, Person Completing Report, Date, Time, Temp when discovered, Temp when discovered, Minimum temp, Maximum temp, Comment optional, and Name and next fill them out.

Finishing refrigerator zer temperature log stage 5

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