We really do not know as to we are right or wrong in asking the following queries as we are facing this situation for the first time in the last 40 years as we never used vaccine which requires minus temperature for storing and shifting before administering at the planning unit level. We have many more queries, but sharing only the following for the time beeing.
All experts in this field, especially the manufacturers can kindly respond for providing quality service to the esteemed beneficiaries.
Queries on Deep Freezer [DF] at the vaccination center at the Facility
1. What is the temperature range recommended for storing in the DF?
2. What minimum "cold hold over time" is expected below permissible upper limit of the range for that vaccine in hours if power fails?
3. Should the deep freezer also be lined with Ice-Lining like that of Refrigerator [ILR]? If yes should it be with icepacks filled with water as thermal buffer or nonfreezing gel? If there is no ice-lining, how many packs & which size packs are recommended to be placed in the cabinet - say 50% space for vaccine, 10-20% for ice-packs, 30 to 40% free space for air circulation or which proportion the company recommends? Often the entire storage pack is totally frosted: stony hard, unable to open the carton and remove the vaccine vials / ampules: which may break in the deep freezer itself causing loss to the buyer unless compensated by the company - say buy 100 get 20 to 25 free.
4. How often de-frosting is recommended and where to and how to transfer the vaccines to alternate cold chain equipment? Non electrical or Electrical? Within how many seconds / minutes?
5. What type of temperature logger is recommended inside the DF? One which can continuosly display outside mounted on the wall / transmits data through SIM which the supplier can access 24 x 7 / data logger with USB…..?
6. At what minimum and maximum temperature beeps are expected? [below -25 0C higher than -15 0C]
7. What is the optimal packing unit for keeping vaccine in the DF? [Cluster of how many secondary packings:50/100/200/300...]
8. What process is recommended for removing secondary packing from storage packing and individual vials / ampules from the secondary packing placed in the DF?
9. Within how many seconds / minutes process mentioned in 8 are to be completed?
10. In which container / tray & at what temperature the secondary packing units / vials / ampules are to be carried to the session site [away from the cold room by say 50-150 mtrs]; how to record and document the temperature from removal from the DF to administration to the candidate with documentary evidence?
11. How to thaw:- allowing it to liquefy on its own on the vaccination table in its trough / gently roll between the palms at 37 0C
12. Towards the end of the session if less than 5 doses are needed what procedure is to be followed? [say 3 more than 100] or how to pull out only 1 to 4 doses from the DF 50 to 150 meters away from the session site?
13. Is a Vaccine Carrier recommended - the brand item in any vaccination session? If so, what size? 1.7L /2.9L / 5L; small ice pack / Large icepack; conditioned [ice-pack at 0+0C] / unconditioned [sub-zero] / with water as thermal buffer or non freezing gel?
14. What should be the temperature within the vaccine carrier if point 13 is recommended: between minus 25 0C & minus 15 0C?
15. Will the manufacturer can share a CD explaining all these and any further step to step activity from receiving the vaccine from the manufacturer till disposal of the cut ampule / opened vial for maintaining universal uniformity including how to provide documentary evidence.
Some questions may look silly but are operationally very important for us. I hope one or more may reciprocate especially the manufacturers of the vaccine with end to end CD for recuurent training of multiple batches.
with great expextations