Evaluation of Vaccine Cold Chain Practices in Healthcare Facilities of the Republic of Korea: A Multi-Site Cross-Sectional Study

초록

Background: This study evaluated vaccine cold chain management and storage practices in Korean healthcare facilities to identify strengths and gaps, with a focus on private healthcare facilities and public health centers. We aimed to assess compliance with national guidelines and World Health Organization (WHO) recommendations on vaccine storage, handling, and emergency preparedness. Methods: A cross-sectional nationwide survey was conducted in 53 immunization service providers (43 private healthcare facilities and 10 public health centers). A structured checklist and questionnaire were used to audit equipment, temperature monitoring, inventory management, and emergency preparedness practices at each site. Key indicators were recorded. Results: All facilities had functional refrigeration for vaccines, with 53 (100.0%) having a dedicated vaccine refrigerator and 4 (7.5%) had a dedicated vaccine freezer. However, 39 facilities (73.6%) had continuous temperature monitoring devices in installed on all of their refrigeration units, and alarm systems were present in 44 (83.0%) of sites. Proper vaccine placement (center shelf, away from vents) was observed in 52 (98.1%) of facilities, and 51 facilities (96.2%) appropriately stored live vaccines to shield them from sunlight. 52 sites (98.1%) maintained up-to-date vaccine inventory records and all sites adhered to recommended procedures for disposing expired doses. Notably, 28 (52.8%) had documented emergency plans, such as a backup system, though fewer, 27 (40.9%), tested their backup power regularly. Conclusion: This nationwide audit reveals generally sound cold chain infrastructure in Korean healthcare facilities, alongside specific deficiencies. While most facilities meet basic standards for equipment and record-keeping, improvements are needed in continuous temperature monitoring, alarm systems, and emergency backup provisions. Strengthening

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