Streamline requirements for vaccine transport?

WHO's “Guidelines on the international packing and shipping of vaccines” clearly defines the temperature conditions for vaccines in three groups of stability up to a maximum travel duration of 48 hours. Guidelines for in-country transport cannot yet be found in a single document but are scattered among several training materials, published articles and manuals with overlapping, inconsistent rationale. The table below summarises the guidance available, both for international and country level transport, and shows that different requirements have been applied to three groups of vaccines. To meet these requirements is complex. Three ‘cold-chains’ are required. But by exchanging views on the following questions, we can post a proposal to WHO for the simplification and streamlining of the procedures for in-country transport: If all vaccines can be transported at +2C to +8C, can we have simply one cold chain for vaccine distribution? Oral polio can be frozen (upper distribution levels) and thawed (lower distribution levels) without compromising safety or performance If we use ‘freeze-free’ carriers and cold boxes for all vaccines, we have simply one cold chain for vaccine distribution? A single policy to only use freeze-free equipment would halt the use of chilled water packs, but reduce the confusion in training for multiple packing methods. The cold chain would ‘reach’ further for outreach, facilitating higher coverage The proportion of vaccines that must not freeze is over 50% and rising; little would be gained by running multiple types of cold chain in parallel If we have one cold chain for all vaccines, we also simplify the task of monitoring temperatures: we can follow four alarms (or less): Minimum +2C, Maximum +8C and Alarms -0.5C+20.0C I look forward to hearing from you! References Guidelines on the international packing and shipping of vaccines; Rev.2, WHO IVB/05.23 http://whqlibdoc.who.int/hq/2005/WHO_IVB_05.23_eng.pdf Kartoglu U, et al. Use of Cool Water Packs To Prevent Freezing During Vaccine Transportation at the Country Level. http://www.epela.net/epela_web/document_lib/Use_of_Cool_Water_Packs_to_Prevent_Freezing_During_Vaccine_Transportation.pdf