Deficits of Vaccine Storage in German General Practices and the Effectiveness of a Web-Based Education Program to Improve Vaccine Storage Knowledge of Practice Personnel (Keep Cool)

Abstract

Maintaining the cold chain of vaccines with a temperature range of 2°C to 8°C is a challenging issue worldwide. Exposure to heat and especially to freezing reduces vaccine effectiveness and tolerability. Prior research revealed cold-chain breaches and heterogeneous vaccine storage practices in German practices but failed to offer broader quantifications or solutions. This PhD project aimed at quantifying vaccine storage deficits (temperature, vaccine storage practices, and personnel’s knowledge) and improving vaccine storage conditions by developing an intervention. The intervention is a web-based education program named ‘Keep Cool’ for general practice teams which was evaluated in teaching practices. <br> At baseline, 75 refrigerators from 64 practices were analyzed: 68.0% (n=51) had cold-chain breaches with 15% (n=11) showing critically low temperatures (<0°C). On average, only 4.7 (standard deviation (SD) =1.9) of ten predefined quality criteria for vaccine storage practices were fulfilled. Following participation in the web-based education program, knowledge on vaccine storage of 60 participants from 25 practices improved from an average of 5.6 (SD=1.9) to 9.8 (SD=1.2) of 11 correct answers (<0.001) immediately after participation in Keep Cool. The widespread dissemination of Keep Cool promises to solve a highly relevant issue for public health that is currently underestimated by general practices and regulatory bodies.