POST 00570E : CONTAMINATION OF OPEN VIALS 8 June 2003
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Lynda Le Le Yi (mailto:[log in to unmask]) Regional Immunization Officer at
the UNICEF Regional Office for South Asia (ROSA) is requesting information
of the degree of contamination of open vaccine vials. Michel Zaffran
(mailto:[log in to unmask]) from WHO is providing an answer, in fact there is
no answer. Michel is also sharing a report by Debra D. Kristensen,
Technical Officer at PATH on a Vaccine Vial Monitor Impact Study in Bhutan.
Although the report is over 3 years old and does not deal directly with the
query as Michel notes, it will nevertheless interest members. It discusses
some aspects of the Open-Vial Policy (by the way it is now called
Multi-Dose Vial Policy (MDVP), especially the importance of respecting time
limits. The attachment is rather large, 385K, thus some members may not
receive it.
Both contributions follow.
Also note that the website has been edited with a new "Best Practice" story
and a new picture for the travel quiz.
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There has been very high vaccine wastage in some areas of countries with
mountains and/or difficult-to-reach populations where vaccinators have to
catch pockets of small groups of populations on and around the mountains.
Vaccinators have been using open vial policy for the DPT, TT and OPV
vaccine vials and the cold chain has been kept well. We would like to know
whether there is information or studies on degrees of contamination when
the used vial is transported from place to place in the field in vaccine
carriers after using 4 or 5 doses at a time from 20 dose vials.
Thanks and best regards.
Dr. Le Le Yi (Lynda)
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To my knowledge, there are no reports on the frequency or the occurrence of
actual contamination of vials taken for outreach. It would also be quite
difficult to conduct such a study to confirm the contamination. Or proxies
would have to be agreed upon (change in color, change in pH (?), ...).
The Policy clearly states that it applies to vaccines taken out for
outreach provided (among other conditions) that the vial septum has not
been immersed in water. The concern has of course been that, in some cases,
outreach is conducted using blocks of ice rather than icepacks which means
that the vials end up floating in water, hence the high risk of
contamination. So in summary, I am not aware of such data and would welcome
any data that could be disseminated to countries. In fact any study on the
extent of the use of the open vial policy would be quite useful.
I attach a study carried out in Bhutan (final report by Debbie Kristensen)
on the VVM and open vial policy-. this is not directly related to the
question but may be of interest.
Regards,
Michel
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