Vaccine Vial Monitor (VVM) - technical resources

jon Pearman

VVMs (Vaccine Vial Monitors) are small indicators that adhere to vaccine vials and change color as the vaccine is exposed to cumulative heat, letting health workers know whether the vaccine has exceeded a pre-set limit beyond which the vaccine should not be used. This page provides a list of useful resources on VVMs, organised into the following sections:

What is a VVM?

The following resources introduce the VVM and explain how it works.

TitleAuthorYearTypeLanguage
Vaccines work - video explainerTemptime2019TrainingEnglish
What is a vaccine vial monitor (VVM)?Gavi, the Vaccine Alliance2019TrainingEnglish

How to read a VVM

Resources that explain how to read a VVM to determine whether a vaccine can be safely used for immunization.

TitleAuthorYearTypeLanguage
Vaccine Vial Monitors (VVM) - Online courseUNICEF2020TrainingEnglish
How does a VVM work?EPELA, World Health Organization (WHO)2020TrainingEnglish
Vaccine vial monitor, PSM LecturesRajeev Ranjan Gupta2017TrainingHindi
How to Read a VVMImmunization Academy2018TrainingEnglish, Hausa, Swahili, French
Vaccine vial monitor (VVM)World Health Organization (WHO)2021Poster/infographicEnglish, Portuguese, Russian, Spanish, French
Immunization in Practice - Module 2: The vaccine cold chainWorld Health Organization (WHO)2015GuidanceEnglish

VVM training videos for healthcare workers

Videos on how healthcare workers should use VVMs.

TitleAuthorYearTypeLanguage
Monitoring the Cold chain: Monitoring Temperatures at health facilitiesImmunization Academy2020TrainingEnglish, French
Monitoring the cold chain: What Temperatures Should Vaccines Be?Immunization Academy2020TrainingEnglish, French
Packing for an Immunization SessionImmunization Academy2020TrainingEnglish, French
What to Do When a Refrigerator Temperature Is Too High or LowImmunization Academy2020TrainingEnglish, Hausa, Swahili, French
Monitoring Vaccine Stock: Monitoring Vaccine and Safe-Injection StockImmunization Academy2020TrainingEnglish, Hausa, Swahili, French
Vaccine Management: Arranging Vaccines Inside Any RefrigeratorImmunization Academy2020TrainingEnglish, Hausa, Swahili, French
Vaccine management: Using Top-Opening Refrigerators Without BasketsImmunization Academy2020TrainingEnglish, French
Vaccine management: Using Top-Opening Refrigerators With BasketsImmunization Academy2020TrainingEnglish, French
Vaccine Management: Using Front-Opening RefrigeratorsImmunization Academy2020TrainingEnglish, French
Using the Multi-Dose Vial PolicyImmunization Academy2020TrainingEnglish, French, Hausa, Swahili
Conducting Supervision: Providing on the job trainingImmunization Academy2020TrainingEnglish, French
Choosing which VVM to dispatch for a lower facilityEPELA, World Health Organization (WHO)2013GuidanceEnglish
TASK - VVM use at the most periphery (outreach)EPELA, World Health Organization (WHO)2013GuidanceEnglish

VVM resources for supply chain managers

Resources that provide guidance for supply chain managers on how VVMs should be utilised by national immunization programs.

TitleAuthorYearTypeLanguage
VVM use at the most periphery - Serge GanivetEPELA, World Health Organization (WHO)2013GuidanceEnglish
WHO policy statement: multi-dose vial policy (MDVP): handling of multi-dose vaccine vials after openingWorld Health Organization (WHO)2014GuidanceEnglish, French
Tools and approaches to ensure quality of vaccines throughout the cold chainJulie Milstien, Umit Kartoglu2014Journal articleEnglish
WHO-UNICEF policy statement on the use of vaccine vial monitors in immunization servicesUNICEF, World Health Organization (WHO)1999GuidanceEnglish, French
WHO-UNICEF policy statement on the implementation of vaccine vial monitors: the role of vaccine vial monitors in improving access to immunizationUNICEF, World Health Organization (WHO)2007GuidanceEnglish
Vaccine Management Handbook: How to use passive containers and coolant-packs for vaccine transport and outreach operationsWorld Health Organization (WHO), UNICEF2015GuidanceEnglish, French

VVM in a Controlled Temperature Chain (CTC)

Resources on CTC with reference to VVMs and Peak Temperature Threshold Indicators (PTTI).

TitleAuthorYearTypeLanguage
Vaccines beyond the cold chain - Simona ZipurskySimona Zipursky, EPELA, World Health Organization (WHO)2013GuidanceEnglish
Benefits of using vaccines out of the cold chain: Delivering Meningitis A vaccine in a controlled temperature chain during the mass immunization campaign in BeninSimona Zipursky, Mamoudou Harouna Djingarey, Jean-Claude Lodjo, Laifoya Olodo, Sylvestre Tiendrebeogo, Olivier Ronveaux2014Journal articleEnglish
Assessing the potency of oral polio vaccine kept outside of the coldchainSimona Zipursky, Liliane Boualam, Dah Ould Cheikh, Jacqueline Fournier-Caruana, Djabar Hamid, Mathias Janssen, Umit Kartoglu, Genevieve Waeterloos, Olivier Ronveaux2011Journal articleEnglish
Extending supply chains and improving immunization coverage and equity through controlled temperature chain use of vaccinesRaja Rao, Debra Kristensen, Anna-Lea Kahn2017Journal articleEnglish

WHO PQS performance specifications

Resources that provide technical reference material on the science behind VVM.

TitleAuthorYearTypeLanguage
[WHO_PQS_E006_IN06.VP.1] Combined VVM and Threshold Indicator Independent type-testing protocolWorld Health Organization (WHO)2020GuidanceEnglish
[WHO_PQS_E006_IN05-VP.4] Vaccine Vial Monitor Independent type testing protocolWorld Health Organization (WHO)2020GuidanceEnglish
[WHO_PQS_E006_IN04.VP.1] Threshold Indicator Independent type-testing protocol World Health Organization (WHO)2020GuidanceEnglish
[WHO_PQS_E006_IN04.1] Threshold Indicators Performance SpecificationWorld Health Organization (WHO)2020GuidanceEnglish
[WHO_PQS_E006_IN05.4] Vaccine Vial Monitor Performance SpecificationWorld Health Organization (WHO)2020GuidanceEnglish
[WHO_PQS_E006_IN06.1] Combined VVM Threshold Indicator Performance SpecificationWorld Health Organization (WHO)2019GuidanceEnglish

Other VVM resources

Journal articles, webinars, and other publications that provide background information on the VVM.

TitleAuthorYearTypeLanguage
Vaccine storage and handling practices among routine immunization service providers in a metropolitan city of north-central NigeriaS. A. Aderibigbe, O. I. Musa, M. M. B. Uthman, O. A. Bolarinwa, A. G. Salaudeen , H. A. Ameen2014Journal articleEnglish
Last mile - Umit KartogluUmit Kartoglu, EPELA, World Health Organization (WHO)2013GuidanceEnglish
Cold chain challenges everywhere - Simona ZipurskySimona Zipursky, EPELA, World Health Organization (WHO)2013GuidanceEnglish
The Book of VVM: Yesterday-today-and-tomorrowUmit Kartoglu2020GuidanceEnglish
Using VVM as a stock management toolÜmit Kartoglu2013TrainingEnglish
Vaccine Vial Monitor (VVM)-based vaccine management - Presentation slidesUmit Kartoglu2020PresentationEnglish
Interpretation of VVM in relation to other temperature monitoring devices - Umit KartogluUmit Kartoglu, EPELA, World Health Organization (WHO)2019TrainingEnglish
Vaccine vial monitor availability and use in low- and middle-income countries: A systematic reviewPär Eriksson, Bradford D. Gessner, Philippe Jaillard, Christopher Morgan, Jean Bernard Le Gargasson2017Journal articleEnglish
Vaccine instability in the cold chain: mechanisms, analysis and formulation strategiesKumru OS et al.2014Journal articleEnglish