TechNet-21 - Forum

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

Dear all

Routine Immunization programme is rapidly expanding in the country, more and more vaccines are included in the National Immunization Schedule [NIS] in phased manner. Rota Virus Vaccine is being introduced in Karnataka. As customary, in Dakshinakannada district, training programmes were held in 2 batches on 17th & 19th July 2019 in collaboration with WHO country office, this will be followed by training at block and planning unit level.

With additional vaccines, additional cold space is required. Most of the multi dose vials have 10 or more doses e.g. 2mL OPV provides 20 doses, 5mL MR provides 10 doses, 2.5mL fIPV provides 25 doses. Currently supplied RVV is unique in the sense 5mL per vial after reconstitution has 2 doses of 2.5mL each. Hence the storage code is revised to accommodate Vaccine Vials if not the diluents.

A Planning Unit in Karnataka is not having more than 30,000 populations, at 20 birth rate; estimated annual target of 0-1year children will be 600, on an average 50 per month. RVV vial requirement is 50 infants×3doses=150×1.11wmf [@90% usage] =166.5 doses +25% buffer stock=166.5+41.65 = 288.15; rounded off to 290. @ 2 doses per vial, 145 vials are needed with 145 diluents and 290 6mL oral syringes. Diluents and oral syringes can be kept outside the cold chain and required number of diluent vials need to be kept in the ILR at least 24hrs prior to the session.

Karnataka has the luxury of having adequate planning units, majority do not have more than 350 children per year at least in the rural area. Author had revised the earlier storage code of 2012 designed for ILR’s with 2+1 baskets [140L] for 300L ILR with 3+2 baskets, submitted to the state government which issued official circular on 29 April 2018 to all the districts and planning units. Now, in view of above it is redesigned for operational use and submitting the draft to the government for needful.

regards

Dr Holla

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Narayana Holla Accepted Answer

Thank you for responding.

What I suggested is for India, in the training programme we were shown 2 doses in one vial and a diluent vial + dropper syringes for reconstittuting and administering. As general guideline, we were told to keep only the vaccine vials insde the ILR and diluents outside the ILR but to keep the required diluents atleast 24 hrs prior to the session.

For statistical exercise we used the formula given by the trainer (10% watsge; 90% usage = WMF is 100/90=1.11). Probaly these training guidelines may vary from country to country.

Population per PHC in rural area is not more than 25,000 in karnataka but in north states in India it will be more than a lakh per PHC.

Redisigning / coding refers to the ILRs already existing with the planning units having 3 baskets in the upperzone and 2 in the bottom zone. This rearrangement will not apply to the ILRs having less than 3 baskets in the upper and 2 in the bottom zone. "BASKET" is the storing "UNIT" space as having baskets in the vaccine storing cabinet space of an ILR is mandatory. ILR cannot be used for keeping vaccine safely if there are no basktets. [while monitoring, ILR with no baskets were also seen and naturally all vaccines were kept in the bottom with no "CODE" - a high risk practice, corrected on the spot]. 100L Ice Lined Refrigerator will not have 3 baskets in the upper zone and 2 baskets in the lower zone.   

 

with regards

Dr Holla n team 

  

 

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

Dear Narayana

Respectfully I want to comment some points of view about your topic.

1. Populations nearby to 30.000 requiere more than one health center. Then those doses are distribuited in at least 3 refrigerators on the town.

2. 166.5 doses + 25% buffer stock = 208.15 not 288.15

3. Is better RVV single dose.

4. ILR with 300 liters of net volume doesn´t exist for example Vestfrost has VLS400A AC with 235 gross volume, BMedical has TCW 4000 AC the biggest ILR with 240 liters.

5. ILR with 100 liters is enough.

Best regads

 

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


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