Dear viewers - Please find the following and the attached illustration for a critical review and needful.
CCH Mrs Anitha Beth and Asst CCH Mr Mukesh could not believe when the author shared his observations that the “T” series vaccines were found in “Frozen” condition at the session site far off from the ILR point. Temperature record book never showed subzero recording on any day. CCH had to distribute vaccines to ~50 session sites on Thursdays and ~30 session sites on Saturdays. In a hurry, unconditioned icepacks were loaded in one of the vaccine carriers at about 7 AM and reached outreach at about 10 AM. Jerky movement during the excursion hastens the process of freezing. All vaccination service providers are aware that frozen “T” series vaccines lose potency and the precipitated particles act as foreign body and may result in cold sterile abscess.
As per the formal training, vaccine vials are to be kept in a Ziploc pouch and placed in the vaccine carrier packed with 4 conditioned ice-packs. In northern states of India, with more than 2Lakh population per planning unit and ~300 outreach sessions per month, often / accidentally unconditioned ice-packs may be placed as in the above instance.
Other common / frequent observations were unclean vaccine carrier, ill fitting lid, no strap to keep the lid in-situ, tampered vaccine carrier, vaccine vials without label, VVM in discard stage, wrong diluent or no diluent, only BCG/Measles/MR/JE, no dropper, only OPV, diluent outside the cold chain in the vanity bag, no starting date on vaccine vials of Open Vial Policy [MDVP] and the like.
And now: Recently, on 21st April 2017, a senior consultant from New Delhi also being directed by his superiors from an international RI development partner agency visited the dedicated vaccination clinic of our KVG Medical College to address above issues, especially to avoid freezing of vaccines in the vaccine carrier while transporting.
In response to this I wish to share the following, practicing in all the 3 Planning Units attached to our college with illustrations.
Transparent plastic container has a screw cap, tapering towards the bottom and is icepack height. Holes are made using heated tip of piston of 2mL glass syringe for sustaining uniform temperature both inside and outside the plastic container within the vaccine carrier.
However; inspite of training, orientation, re-orientation; passionate Sustained supportive supervision is indispensable, helps in hands on training, maintains perfection of the programme.
Anticipated benefit: Apart from ensuring delivery of quality vaccine, this incurs negligible expenditure, aesthetic, easy to operate and can save millions of $ on operational research of designing new generation vaccine carrier.
Sharing with the viewers for comments / sharing their experiences in this field.