All vaccines are shipped with a cold pack. We must ship all vaccines via 2nd day air unless a quicker method is requested. Pox Vaccine must ship Next Day Air. (Additional shipping charges apply.) Bring vaccines to room temperature before use. PMV1, Sal-Bac and Quatracon include a free syringe and needle. Antibiotics should not be used for 5 days before or after a vaccination. Antibiotics can decrease the vaccinations effectiveness. You should give a mixture of vitamins and immune boosters before, during and after vaccinations. This may increase the success of the vaccination.