POST 00960E : VVM USE / INDONESIA 5 August 2006
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Anton Widjaya (mailto:[email protected]) and Vanda Moniaga
(mailto:[email protected]) both from PATH/Indonesia share the following
experience on VVM use.
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Use of Vaccine Vial Monitors to Manage Vaccines after the Recent Earthquake
in Yogyakarta
Indonesia has applied vaccine vial monitors (VVMs) to all its EPI vaccines
except for the BCG vaccines (due to economic reasons). It is used
forMeasles, OPV, DTP and DTP-HB, HB, TT and DT vaccines. This application
is very helpful to supplement the "Earliest Expiry First Out" (EEFO) system
and it improves the confidence of the health workers at all service levels
regarding the "quality" of the vaccine to be delivered.
During the May 2006 earthquake centered in Yogyakarta (on the island of
Java in Indonesia), much of the infrastructure was damaged including the
cold store facilities at the district and health centers. Electricity
supply was out for some days and generators were not functioning or used.
By observing the VVM condition on the vaccines, health workers were able to
decide which vaccines were still viable for use and which needed to be
discarded. In the disaster areas, VVMs on the OPV vials were already
reaching the usage limit, giving visual indications to health workers that
vaccines needed to be discarded and re-supplied. The other vaccines with
VVMs still showing good condition were not discarded and could still be
used to reduce wastage. As for the BCG, the MOH decided to discard all BCG
vaccines because there was no indicator to show the heat exposure effect in
a non-functioning cold chain condition. In total, vaccine in 5 districts
and more than 50 health centers (an estimate of up to 50,000 doses) was
saved from being wasted due to the presence of VVM on the vials. The
practicability of VVM as an indicator that can be read visually without any
accessory devices is a great advantage. This is one example how the use of
VVM is able to reduce vaccine wastage and improve health workers'
confidence in vaccine quality before administration.
Anton Widjaya and Vanda Moniaga
PATH/Indonesia Immunization Team
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