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Vaccine supply, distribution and storage

  • Last modified date:
    1 March 2011

Key information on how to order vaccines, and guidelines for vaccine storage

Vaccine supply

The successful delivery of immunisation programmes requires adequate and efficient supply of vaccines to providers. There are two different systems in place:

  • the central purchase of vaccines for the national childhood immunisation programme, and
  • direct purchasing from suppliers for the adult programmes and other vaccines.

General information on the storage, distribution and disposal of vaccine is provided in Chapter 3 of Immunisation against infectious disease, DH 2006 (The ‘Green Book’). The Green Book also provides a section on vaccine supplies at the end of each disease-specific chapter (Chapter 13 onwards).

Centrally purchased vaccines available for order

DH vaccines available to order from Movianto UK are:

  • DTaP/IPV/Hib (Pediacel, for primary immunisation only)
  • PCV (Prevenar 13)
  • MenC (Menjugate Kit and Neisvac C)
  • Hib/MenC (Menitorix)
  • MMR (MMRvaxPRO, Priorix)
  • DTaP/IPV, dTaP/IPV (Infanrix/IPV, Repevax)
  • Td/IPV (Revaxis)
  • BCG
  • PPD 2TU
  • PPD 10TU
  • HPV (Cervarix)
  • Seasonal influenza vaccine for poultry workers (the brand available may change each year)

Different brands of the same vaccine are usually interchangeable - details are provided in the Green Book and Vaccine Update.

Orders can usually be placed for any vaccine brand, although on occasion central stock management requires the temporary use of one particular brand and orders will be filled with the brand available. To reduce the quantity of vaccine being held locally, and to preserve central supplies, it may also be necessary to cap orders to a set amount, sometimes without prior notification, and to supply vaccines ‘on allocation’. Any changes are notified in Vaccine Update, in advance whenever possible.

Order team telephone number: 01234 248631
Vaccine ordering customer care: 01234 248632

Vaccines for the routine childhood immunisation programme

Vaccines are centrally purchased for the UK by the NHS Commercial Medicines Unit (NHS CMU) on behalf of the DH and the devolved administrations. Vaccines are distributed, free of charge, to the NHS in England by a private distribution company (distribution arrangements in the devolved administrations may differ). Currently this company is Movianto UK (formerly Healthcare Logistics Ltd and previously called Farillon Ltd).

Other vaccines

All other vaccines, including influenza and pneumococcal (PPV), are bought direct from manufacturers or wholesalers as a private contractual arrangement not subject to any DH involvement.

The supplier is generally the company who manufactures the vaccine, but this is not always the case with influenza vaccines and some travel vaccines. The vaccine is delivered direct from the supplier, or a company they have contracted to make deliveries on their behalf.

Movianto UK also deliver vaccines, including influenza vaccine, on behalf of vaccine suppliers - these are separate contracts from the ones Movianto have with NHS PASA (on behalf of the DH) for influenza and childhood vaccines

Vaccines for occupational health use

All vaccines needed for occupational health purposes should be obtained direct from the manufacturer or supplier. Details of where to buy vaccines are available in the British National Formulary (BNF).

Other vaccine products purchased by the DH

The DH also centrally purchases the following products:

  • anthrax vaccine
  • rabies vaccine
  • botulinum antitoxin
  • diphtheria antitoxin
  • hep B immunoglobulin
  • normal immunoglobulin
  • rabies immunoglobulin
  • varicella zoster immunoglobulin

These products are available from the HPA. Please note that rabies vaccine is only available for emergency use. For prophylactic use it should be bought from the suppliers (supplier details are available in the BNF). Guidance on situations where these other products should be used is given in the BNF and the Green Book.

Antivenoms for emergency use in the UK against snake, spider and stone fish bites/strings can be obtained from:

Guy’s and St Thomas’ Poisons Unit
0207 7327502 (24 hours a day)

The Royal Liverpool and Broadgreen University Hospital
0151 706 2096 (office hours)
0151 706 2000 (out of hours ask for on call pharmacist)

Vaccine costs

Vaccines are expensive and any immunisation programme has to minimise wastage. The DH currently spends around £150 to £200 million a year on vaccines for the childhood immunisation programme for children up to the age of five years in England alone.

Reducing vaccine wastage and cold chain compliance

Vaccine wastage is costly and can disrupt the delivery of immunisation. Poor storage practices are a key cause of vaccine wastage. This section gives advice and guidance on these related issues.

Vaccine wastage and loss of potency due to adverse storage conditions

Vaccine wastage has the potential to be both very costly and to disrupt the efficient delivery of the immunisation programme. Most importantly, poor storage practices, a key cause of vaccine wastage, may also result in children being vaccinated with products that have lost potency due to those conditions and therefore being left vulnerable to vaccine-preventable disease.

It is important that there is strict adherence to good vaccine storage policies, which must include the monitoring and maintenance of all vaccine fridges to the recommended standards. All vaccines are sensitive to heat and cold and the vaccine’s effectiveness cannot be guaranteed unless it has been stored at the correct temperature.

Storage of vaccine and maintenance of the cold chain

If vaccine is needed to be transported locally, the guidance in Chapter 3 of Immunisation against infectious disease, DH 2006 (The ‘Green Book’) should be followed.

Each surgery or pharmacy should have a trained individual - with at least one trained deputy - responsible for the receipt and storage of vaccines and the recording of the maintenance of the cold chain from receipt of the vaccine onwards.

A regular audit, at least annually, should be undertaken by surgeries and clinics to ensure full compliance with cold chain requirements. Local examples of cold chain audits are available. Surgeries and clinics will also need to regularly do fridge checks at other times, for instance when receiving deliveries of new vaccines.

PCTs should promote and encourage audits to ensure vaccine efficacy, and this is relevant for all the vaccines being held in surgery fridges. PCTs should consider organising a structured PCT-wide audit to ensure all vaccines are being ordered, stored and disposed of correctly, and appropriate records kept.

Random spot checks of the cold chain and storage arrangements by influenza coordinators or other appropriately trained and qualified clinical staff could be undertaken during the flu season, when surgeries will be holding a large amount of vaccine, to make sure the recommendations are being understood and followed.

It is recommended that PCTs ensure that there is a local assessment of the robustness of compliance with the supply cold chain during vaccine transport and distribution, particularly when stock is redistributed locally in times of shortage.

Domestic cool boxes should not be used to store, distribute or transport vaccines. Validated cool boxes (with maximum-minimum thermometers) and ice packs from a recognised medical supply company should be used and individual manufacturers’ instructions should be strictly followed.

Vaccines must be kept in the original packaging, wrapped in bubble wrap (or similar insulation material) and placed into a cool box with cool packs as recommended by the manufacturer’s instructions. This will prevent direct contact between the vaccine and the cool packs and will protect the vaccine from any damage, such as being frozen.

Key messages for those managing vaccine supply locally

When ordering:

  • only order vaccine when you have less than two to four weeks’ worth of stock in the fridge
  • you can make weekly orders, so it’s best to order smaller amounts regularly
  • order by pack, not by dose
  • check Vaccine Update newsletter for latest information.

When receiving an order:

  • check your order thoroughly when it arrives, it can’t be taken back afterwards
  • refrigerate the stock as soon as you have checked it off against the order
  • place the new stock towards the back of the fridge so the shortest-dated stock is used first
  • do not overfill the fridge, as this restricts airflow.

When stocking/restocking fridges/using vaccines:

  • check expiry dates regularly – never use out-of-date vaccine
  • keep vaccines in their original packaging in the main part of the fridge, not in drawers
  • keep your fridge door locked at all times
  • keep the opening of the fridge door to a minimum
  • use a maximum-minimum thermometer and keep a daily record of the temperatures
  • have back-up storage for your vaccines in case of power failure
  • position the fridge away from heat sources and mark or tape the fridge plug to avoid it to being turned off
    (poster and stickers are available - see below).

Additional advice and information

Please email to:

  • request information or advice on any vaccine supply issue, including childhood vaccines
  • be put on the mailing list for the monthly immunisation newsletter Vaccine Update. This newsletter contains information on vaccine supply issues and other general immunisation news.

Key sources of guidance and information about vaccine storage

Chapter 3 of Immunisation against infectious disease, DH 2006 (the 'Green Book'), 'Storage, distribution and disposal of vaccines' states national policy and is the key reference for local policy development. (See link on the left hand).

Another source of practical advice is pages 13 to 17 of UK guidance on best practice in vaccine administration:

Resources to support maintenance of the cold chain

The ‘Keep your vaccines healthy’ poster reminds staff of the importance of careful ordering and storage of vaccines. Display of this poster alerts clinical staff to the care and attention needed for effective vaccine storage. Stickers are also available which can be adhered to an electric plug or socket.

Teaching and education resources

A set of training slides produced by the HPA provide a useful summary of the key facts on vaccine storage and handling.

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