Not only do vaccines need to be kept cold during storage but they must also be kept cold during handling. When live vaccines are moved from the central cold store to a clinic or hospital they should be moved in a cool box. They should also be kept in a cool box in the clinic after the vial has been opened. Vaccines must be kept cool continuously at 2–8 °C. Measles and MMR are commonly inactivated by not being kept cool continuously. From the time the vaccine is produced to the time it is given it must be kept cold. The chain of travel from factory to store to health clinic to patient is called the cold chain. If possible, vaccines should be kept in a separate vaccine fridge at the health facilities. There must be a temperature chart on the vaccine fridge and the fridge temperature should be recorded twice a day. Where gas fridges are used a spare gas tank must be at hand. The expiratory date on vaccines is only valid if they have been kept cool during transport and storage.
Vaccines must be kept cool at all times.