POST 01020E : VACCINE OUT OF THE COLD CHAIN
Follow-up on Posts 01007E and 01013E
4 December 2006
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This posting contains two contributions in
response to Serge Ganivet's question. The first
is from Souleymane Koné (mailto:
[email protected])
from WHO in Geneva, and the second from Andy
Tucker (mailto:
[email protected]) from the United States.
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The question raised by Serge is very relevant and right to the point.
If it is possible to use the "out of the cold
chain" strategy for the birth dose for a given
vaccine, it is therefore possible to apply it for
all other immunization for the same vaccine. WHO
document "Getting started with vaccine vial
monitors, WHO/V&B/02.35" (pages 7-9) concurs with
this logic. Discussions are underway with PATH to
refine the "out of the cold chain" strategy and
define a more formal framework for its application.
I thought that successful application experiences
of "out of the cold chain" strategy somehow
stemmed from opportunities and problems (pressing
ones) to be solved. This is the case with the
administration of the birth dose and some others
by mass immunisation, for which the usual
strategies (fixed, mobile/outreach) were
obviously not of great help. Indeed to ensure the
administration of a HepB vaccine dose within the
first 24 hours following birth is a major
challenge for many a programme, especially when
the majority of deliveries take place at home.
Therefore it were more sensible to have the birth
dose administered by "traditional midwives" whose
assistance is essential. Since extending the cold
chain to homes is inconceivable (to cover the
thousands of midwives scattered in villages with
very little infrastructure), one can easily
imagine however that it would be easier, with the
help of VVM, to take the vaccine “out of the cold
chainâ€