Why are vaccine fridges so expensive?
Background
Before talking about what makes a vaccine fridge unique, it is important to understand why they need to do it. Vaccines are temperature sensitive. Like milk, if you let it get too warm, it will have a shorter shelf life. But milk can be frozen and still used. Vaccines can not be frozen. It kills them. There are some exceptions, but overall, frozen vaccines are dead vaccines.
In Australia the requirement is for vaccines to be stored between 2°C and 8°C. There was a big campaign to “Strive for 5”
The aim of a vaccine fridge
So if vaccines must be stored between 2° and 5° the aim of a vaccine fridge is to reliably control the temperature between these ranges.
The aim of a domestic fridge is to “try to keep my stuff cool”. How often have you pulled out a frozen item out of your fridge?
This article will cover the differences between a domestic and vaccine fridge. There are now a number of domestic fridges that have many of these advanced features and this will increase with time.
The special features of a vaccine fridge
Probably the biggest difference is that a vaccine fridge has a micro-processor (like a computer) controlling it. It determines when the fridge compressor should turn on and off. A domestic fridge has a dial that turns the compressor on, and no control over when it should turn off.
The next big difference is that a vaccine fridge is fan forced. This ensures a more even temperature distribution throughout the fridge. This is similar to a fan forced oven. Over stocking a fridge will compromise this and the reason why you should buy a larger fridge if possible.
The built-in processor offers extra capabilities as well. Displaying the temperature on the outside of the fridge allows staff to check what is going on. This is an expensive thermometer but it is critical that staff are aware of the temperature sensitivity of the vaccines.
The vaccine fridge will also have a number of alarm options. This will include a local buzzer or siren, but can also include external alarm capabilities. So if the door is left open then staff will be quickly notified. In a domestic fridge there are no alarms and it isn’t until the next person uses the fridge that the problem is found.
One feature that I feel is important is a non-exposed cooling plate. Not all vaccine fridges have it, and it makes it possible for product to be pushed against the cooling plate.
Glass doors are also an optional feature. Some people like them because it means the door doesn’t have to be held open, but it does impact on the fridge’s ability to retain heat if power is lost.
It's all about reliable temperature
So a vaccine fridge has a micro-processor to ensure the compressor turns on and off at the correct temperatures, displays the temperature, has an alarm if a problem occurs. The fridge itself has a fan to circulate the air.
vaccinetemperature.com.au has further information on vaccine storage as well as a free poster offer.
Why domestic fridges just aren't up to the task
The location of the temperature sensor
In a food or drinks fridge, the aim is to keep them cold. So the goal is to then find the warmest part of the fridge and ensure it is at the right temperature. The warmest part of the fridge would be the front (because it is exposed to air first when the door opens) and probably at the top (though front to back matters more than top to bottom). So fridge manufacturers placed the sensor at the front of the fridge.But vaccines are more sensitive to freezing than being warm and so the aim of a vaccine fridge is to ensure that the vaccines don’t freeze.
But if the sensor is at the warmest part of the fridge then it has no true idea as to the temperature at the coldest part.
In one recent incident, simply moving the sensor from the front of the fridge to halfway into the fridge made a huge difference to the performance. Let me be totally clear at this point – if you looked at the fridge temperature on the controller it looked no different. It thought it was doing exactly the same job and the results on the display were no different. BUT the temperature loggers that were placed in various locations throughout the fridge gave a very different picture of what was happening. The back of the fridge was no longer freezing and the front of the fridge was still at a good temperature.
Exposure of the cooling plate
There are models that have the cooling plate exposed within the fridge and other models that will have a barrier between it and the contents of the fridge. If the fridge is working optimally this won’t make a difference. But if there is insufficient air-flow then an exposed cooling plate can potentially lead to freezing of the product closest to it.
Which does lead onto the one factor that is within the owner’s control – the size of the fridge. If the fridge is too small then it will be over stocked. An over stocked fridge will block the air-flow. But being fan-forced is one of the critical features of a vaccine fridge. This then means that there will be hot and cold spots within the fridge
Is it worth the money
As a supplier of temperature loggers, I know how many domestic fridges have been freezing vaccines. As a parent, I would now say that I would never get a vaccine from anyone who stores it in a domestic fridge. So as an end user, I think they are worth every cent.
As a pharmacist or GP, the loss of revenue and ability to deliver vaccines can rapidly become an expensive exercise when a fridge does fail. Vaccine fridges have significantly reduced the wastage of vaccines and lost revenue.
The true cost, however, of poorly stored vaccines is passed onto the patient who is treated with a useless vaccine. For many people they will be surprised when they have a disease they thought they were immunised against. For some, however, it will have lasting effects for the rest of their life.
Comparing Vaccine Fridges
Beware. Not all vaccine fridges are the same!
Common Features
We now monitor thousands of vaccine fridges and consequently we get calls from clients to discuss some of the issues they are having. And I would have to say that all vaccine fridges are not the same.
There are a number of features common to most (all?) vaccine fridges including:
- Fan forced air which ensures that there is a more even temperature distribution throughout the fridge. Much like a fan forced oven, except obviously cold.
- Computer controlled with the compressor turning on and off in a more controlled manner. A domestic fridge typically has a vague temperature indicator as to when the compressor will turn on and then turns off again after a set time. Vaccine fridges turn on at a set temperature and turn off again at a set temperature.
- External temperature display so that staff will always know the fridge is working correctly
- Alarms including an audible alarm so that if something goes wrong staff will be notified immediately.
Optional Features
And then there are features that are optional including:
- Glass doors which allow staff to find an item before opening the door, but at the cost of thermal insulation for when the power fails. They will heat up faster.
- Alarm dialler and other alarm features so that staff can be notified when not present
- Built in loggers or external loggers. We strongly recommend an independent logger but that’s not what this blog is about.
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