A dedicated fridge (the same type as that used in the home) with a freezer compartment and 3 shelves must be made available at every site where immunisations are given. The main section of the fridge must be kept at 2–8 °C while the freezer compartment will be below 0 °C. This fridge must be used for vaccines only. Medicines, drugs, formula feeds and food must not also be kept in the vaccine fridge as repeated opening and closing of the fridge door raises the fridge temperature and this may damage the vaccines.

The coolest part of the fridge that does not freeze is the top shelf (below the freezer compartment). This is the best place to store polio and measles vaccines. Other vaccines (BCG, Hib, DPT, DT, TT, HepB and diluents) are best stored on the middle shelf. A fridge thermometer must be kept on the middle shelf and the temperature measured and recorded daily. The thermostat of the fridge must be adjusted to keep the temperature between 2 and 8 °C. If the fridge is warmer or freezes, vaccines may be damaged.

Bottles of water should be stored on the bottom shelf as this helps to maintain the correct temperature in the fridge if there is a power failure. The freezer compartment can be used to freeze and store ice packs and ice cubes for use in cool boxes. The door must be kept closed at all times except when removing or replacing vaccines.