Vaccine Temperature Log Book · Office/Facility: If the temperature is outside +2 °C to +8 °C, contact your public health unit immediately. Week 1

______________________________________

____________________________________________

___________________________________________

_______________________________________________

Public Health Unit:

Website:

Telephone:

Fax:

This document contains both information and form fields. To read information, use the Down Arrow from a form field.

Vaccine Temperature Log Book

Public Health Unit Contact Information

Always keep your vaccines refrigerated between +2 °C to +8 °C.If the temperature is outside +2 °C to +8 °C, contact your public health unit immediately.

This page has been intentionally left blank.

Protecting Ontario’s Vaccine Supply• Alwayskeepvaccinesrefrigeratedbetween+2°Cto+8°C.

• Neverleavevaccinesoutoftherefrigerator.

• MonitorrefrigeratortemperaturesandrecordtwicedailyintheTemperature Log Book.

• Resetthemaximum-minimumthermometeraftertemperaturerecordings(ifapplicable).

• Storevaccinesonthemiddleshelvesoftherefrigerator,neveronthedoororinthedrawers.

• Checkvaccineexpirydatesregularly.

• Alwaysusevaccineswiththeearlierexpirydatefirst.

• Ordernomorethanaone-monthsupplyofvaccineatatime.

• Callyourpublichealthunitimmediatelytoreportvaccinesthathavebeenexposedtotemperaturesbelow+2°Cand/orabove+8°C.

• NEVERadministerordiscardexposedvaccineuntilyourpublichealthunithasassessedthesituation.Keepexposedvaccinesintherefrigeratorbyplacingthesevaccinesinalabelledcontainer(orbag),markedwiththedateandtimeand“DONOTUSE.”

• Spoiledorexpiredvaccineshouldalwaysbereturnedtoyoursourceofsupply(i.e.,publichealthunitorOntarioGovernmentPharmaceuticalandMedicalSupplyService(OGPMSS).

• ReorderTemperature Log Books:– OutsideToronto,throughyourpublichealthunit.– WithinToronto,throughtheOGPMSSat416-327-0837.

Week 1 Mon 3 Tue

4 Wed 5 Thur6 Fri 7 Sat

8 Sun 9

Time AM PMAM PM

AM PMAM PM

AM PMAM PM

AM PM

Current Temp 5.8 7.03.4 5.6 5.7 6.8

3.2 5.3 5.3 5.27.0 6.5 6.0 6.7

Max Temp 6.8 6.56.0 6.8 6.7 7.1 10.4

6.9 6.3 6.4 5.65.2 4.5 5.5

Min Temp 3.4 3.52.9 3.3 3.4 4.0

2.5 3.0 -0.2 3.6 7.07.5 6.5 7.8

Initials AB AB AAAA AA AA AA

AA AA AA ABAB AB AB

Week 2 Mon Tue

Wed Thur Fri

Sat Sun

Time AM PMAM PM

AM PMAM PM

AM PMAM PM

AM PM

Current

Max Temp

Min Temp

Initials

Week 3 Mon Tue

Wed Thur Fri

Sat Sun

Time AM PMAM PM

AM PMAM PM

AM PMAM PM

AM PM

Current

Max Temp

Min Temp

Initials

Week 4 Mon Tue

Wed Thur Fri

Sat Sun

Time AM PMAM PM

AM PMAM PM

AM PMAM PM

AM PM

Current

Max Temp

Min Temp

Initials

Week 5 Mon Tue

Wed Thur Fri

Sat Sun

Time AM PMAM PM

AM PMAM PM

AM PMAM PM

AM PM

Current

Max Temp

Min Temp

Initials

Month:Office/Facility:MM/YY

If the temperature is outside +2 °C to +8 °C, contact you

r public health unit immediately.

ABC Family Practice

January, 2011

SAMPLE

Office/Facility:

If the temperature is outside +2 °C to +8 °C, contact your public health unit immediately.

Week1 Mon Tue Wed Thur Fri Sat Sun

TimeAM PM AM PM AM PM AM PM AM PM AM PM AM PM

CurrentTemp

MaxTemp

MinTemp

Initials



Current

MaxTemp

MinTemp

Initials



Current

MaxTemp

MinTemp

Initials



Current

MaxTemp

MinTemp

Initials



Current

MaxTemp

MinTemp

Initials

Month and Year:


Office/Facility:



CurrentTemp

MaxTemp

MinTemp

Initials



Current

MaxTemp

MinTemp

Initials



Current

MaxTemp

MinTemp

Initials



Current

MaxTemp

MinTemp

Initials



Current

MaxTemp

MinTemp

Initials

Month and Year: