POST 00964E : VVM USE / INDONESIA

POST 00964E : VVM USE / INDONESIA Follow-up on Posts 00960E and 00962E 18 August 2006 ______________________________________________________________ Pradeep Haldar (mailto:[email protected]) from India, makes some clarification about Vijaya Kiran's contribution. Then Debra Kristensen (mailto:[email protected]), Anton Widjaya (mailto:[email protected]), and Vanda Moniaga (mailto:[email protected]), all from PATH reply to Vijaya Kiran's message. _____________________________________ I would like to make certain clarification that the MYP document of Government of India does not commits to open vial policy. The reasons for this is that though there are VVM which changes colour when exposed to higher temperature but as on date there is no VVM for freeze indicator. In our experience we have seen that the frequent abuse for T series vaccine and Hepatitis B vaccine is due to exposure to sub zero temperature. Dr Pradeep Haldar Assistant Commissioner (UIP), Department of Family Welfare, Ministry of Health & Family Welfare, Government of India ---------------------------------- Greetings. We'd like to attempt to answer Dr. Kiran's questions... 1. TEMPTIME, the VVM manufacturer, can provide detailed information on pricing and we encourage them to post a summary. VVM price varies according to label type, VVM type, and quantity purchased. Vaccine producers also incur some costs in handling and applying the labels. 2. WHO determines the type of VVM that should be used for each vaccine supplied through UNICEF based on stability data provided by the individual vaccine producers. Currently, most measles vaccine supplied through UNICEF has a VVM14 (the number represents the number of days that the VVM takes to reach end-point at 37 C). One measles vaccine has a VVM7. BCG vaccine has either a VVM14 or a VVM30. If you are interested in knowing the VVM type on an individual vial of vaccine, the number is actually printed on each VVM. 3. Here's a brief summary of the results of a small study conducted by PATH in Jakarta in September 2002 using chilled water packs: - A vaccine carrier with 4 chilled water packs was able to maintain temperatures below 8 C for 27 to 40 hours (ambient temperature was 26-31 C and the initial temperature of the cool packs was 2 C). - A thermos flask with 3 small chilled water packs maintained temperatures below 8 C for 6 to 8 hours (ambient temperature was 26-32 C and the initial temperature of the cool packs was 4-6 C). 4. There are many ongoing vaccine stabilization projects. PATH is conducting R&D on a portfolio of technologies under a grant from the Bill & Melinda Gates Foundation. WHO has a multifaceted role as well that can best be described by WHO representatives. In addition, three groups have received funding through the Bill & Melinda Gates Grand Challenges in Global Health initiative that is managed by the Foundation for the National Institutes of Health (see http://www.grandchallengesgh.org/subcontent.aspx?SecID=418). We hope to share an overview of PATH's project at the upcoming TechNet meeting. The most exciting news is that we've developed a successful method to protect vaccines containing aluminum adjuvant (e.g. DPT and hepatitis B) from freeze-damage (even after repeated freeze-thaw cycles at temperatures as low as - 80 C) and are preparing for initial clinical trials. We are also working with a collaborator to further improve the heat stability of this group of vaccines and have achieved initial success with hepatitis B vaccine that remains stable for 12 weeks at 55 C. Other research is ongoing with measles, meningococcal A, and DPT vaccines. We hope the above is useful. All the best, Debbie Kristensen (Seattle), Anton Widjaya (Jakarta), and Vanda Moniaga (Jakarta) PATH ______________________________________________________________________________ All members of the TechNet21 e-Forum are invited to send comments on any posting or to use the forum to raise a new discussion or request technical information in relation to immunization services. 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