TechNet-21 - Forum

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  1. Narayana Holla
  2. Cold chain equipment
  3. Sunday, 21 April 2019

Dear all

Context:

A visiting officer was discussing about as to how to practically keep vaccines in the cold-chain equipment at service points / planning units. Visiting officer was also discussing as to why the domestic refrigerator is not recommended by the CDC even for keeping vaccines as alternate equipment. On completing the discussion, thought of presenting the same in the coming Academic Society Meeting for the benefit of staff nurse, medical students, interns, post graduates who may have to provide vaccination services in their profession. Hence, we made this PPT using the photos taken at different planning units in different districts and states at different times for illustration. This is the draft PPT for presenting on 24-04-2019.

Happy viewing

Holla n Team

Attachments (1)
Narayana Holla Accepted Answer

Dear Viewers

In the PPT, slide 2 which was taken from one of the training PPTs, gradient location of Heat sensitivity of Measles was shown common for both "before and after reconstitution". However as per the WHO literature and the suggestion given personally by a senior consultant in this field, the Lyophilized Measles vaccine is "extremely stable at temperatures below zero degree Celsius". 

Hence I have attached edited slide number 2 as the reconstituted is highly sensitive to heat, to be used  within 6 hours of reconstitution, maitaining the reconstituted vial below 8 degree C, away from light. 

Thanks to sir for the sugestion and the reference shared.

Best wiahes 

Holla n team

 

 

Attachments (1)
  1. more than a month ago
  2. Cold chain equipment
  3. # 1

Dear Narayana

Inside of ILR PQS approved doesn´t matter the location of vaccines. The gradient is less than 2°C, in any place the temperature never will transpassing the range 2°C to 8°C. The unopened vaccines inside of ILR is better putting in its original boxes, no inside glass or plastic jars. The plastic boxes with opened vaccines doesn´t need to do holes. ILR with PQS doesn´t have stainless steel in internals walls like in the images and doesn´t requiere putting icepaks around the vaccines, the maker put those icepacks between the walls external and internal.

Best regards.

  1. more than a month ago
  2. Cold chain equipment
  3. # 2
Narayana Holla Accepted Answer

Dear Rafael Hernan Rivera

Thank you sir for the response. As you said vaccines need to be staked between 2 to 8 degree C in the cabinet space, need not be as per the gradient. But in the training modules the packings' are kept in tiers as per the gradient and one above the other. To remove OPV / Measles / BCG from the bottom basket, the upper baskets along with all vaccines are to be kept in the room - usually on a cot / table nearby subjecting to TEs. In one of the blocks in North state, outreach session per month in a planning unit was >330. Not so in Karnataka state. Long back in 2011 I posted regarding keeping vaccines in the cabinet space in containers - one per vaccine. 

In the planning units in Karntaka, on an average for 25,000 population, annual target of 0-1 year children is not more than 500, monthly not more than 42. No single vaccine vial is required >10-12. A carton has average 50 vials and hence no planning unit will receive vaccines in cartons (original packings'). They receive loose vials. IPV vials have often either 25 or 50 ID doses of 0.1mL per dose. Required vials per month is 2 (50 dose ID) or 4 (25 dose ID). Dummy cartons are not available. Holes are made mainly because the container is made "useless for any other purpose!!"

A couple of years back I shared a ppt on "Utilization of cold space". I wish to share the same with you purely for technical sharing / improving from my side.

In the picture, ice-lining is concealed, extra icepacks are in the chamber as the vaccines quantity is too low e.g 2 vials of IPV for one month.....

Other points I do agree with you but in India to get ILR which is available with public sector is very difficult. Deep freezers are available. Locally made are available but costlier. Hope in the future with PPP, public sector may extend the right equipment blended with proper training of cold chain handlers and extended supportive supervision to the private sector.

regards

Holla

 

 

  1. more than a month ago
  2. Cold chain equipment
  3. # 3


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