COLD CHAIN MANAGEMENT - ENGLISH
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COLD
CHAIN IN VACCINATION-
“cold
chain” is a system to maintain vaccine
quality from the time of manufacture until the point of administration
by ensuring that vaccines are stored and transported within the recommended
temperature ranges.
The
system used for storing vaccines in good condition is called the cold chain. It
is sometimes referred to as the vaccine supply chain, or the immunization
supply chain. The cold chain consists of a series of links that are designed to
keep vaccines within the recommended temperature ranges, from the point of
manufacture to the point of administration
WHY
COLD CHAIN
Excessive
heat or cold exposure damages vaccine, resulting in loss of potency. Once
potency is lost, it can never be restored. Furthermore, each time vaccine is
exposed to heat or cold, the loss of potency increases and eventually, if the
cold chain is not correctly maintained, all potency will be lost, and the
vaccine becomes useless.
ELEMENTS
OF COLD CHAIN
Ø
Personnel to
manage vaccine distribution
Ø
Equipment for
vaccine storage & transport
Ø
Maintenance of
equipment
Ø
Monitoring
Ø
Personnel to manage vaccine distribution
Ø
There should be a
designated and trained personnel (cold chain handler) in handling cold chain
and distribution of vaccines at all levels including center, state, district and
all health facilities of cold chain equipment and vaccine distribution .
Ø
Equipment for vaccine storage & transport
Cold
chain equipments includes-
Ø
Walk in coolers- These are big equipments of cold chain system like a room. These are
used at regional level vaccine storage system. Temperature range 0-25 degree
can be maintained in these coolers. These are also known as walk in cold rooms.
Ø
Deep freezer- Deep freezer is used at district and CHC level. A temperature range of
-20 to 25 degree can be maintained in deep freezers. It is used to store polio
vaccine and to freeze ice packs.
Ø
Ice-Lined
Refrigerator (ILR)- Ice lined refrigerator (ILR) is used at approximately all
the vaccine storage facilities. A temperature range of 2-8 degree in maintained
in ILR.
Ø
Cold Box - It is a thermo-insulator box which is used to transport vaccines.
freezed ice packs are placed at bottom, sides and top of vaccines to be
transported inside the cod box.
Ø
Refrigerator- It is a simple refrigerator and used at PHC or sub-center level to
maintain cold chain for vaccines. WHO recommended refrigerator is slightly
different form domestic refrigerator.
Ø
Vaccine carrier- It is also a thermo-insulator box having strips to carry at the point
of vaccination. 4 ice packs are kept inside to maintain recommended temperature
to vaccines.
Ø
Ice pack- It is plastic box which is filled with water and freezed in deep
freezer. After freezing these are used in cold boxes and vaccine carriers to
keep vaccines cold.
Ø
Ø
Maintenance of equipment
Ø
All cold chain
equipments should be well maintained. They should have dedicated switch board
for electrical supply.Cold chain handler should take care to defrost the
electrical equipments (deep fridge, ILR and refrigerator ) regularly as and
when needed. Do not let ice deposition more than 0.5 cm thick
Ø
Remove all the
vaccines and transfer them to another refrigerator or to a cold box or vaccine
carrier lined with conditioned ice packs.
Ø
Switch off the
electrical supply for the
ILR/refrigerator.
Ø
Leave the door
open and wait for the ice to melt. Never try to remove the ice with a knife or
ice pick; this can permanently damage the ILR/refrigerator. A pan of boiling
water can be placed inside and the door closed.
Ø
Clean the inside
of the ILR/refrigerator and door seal with a clean damp cloth.
Ø
Re-start the
ILR/refrigerator. Do not adjust the thermostat.
Ø
When the
temperature in the main section falls to +8 °C or lower (but not less than +2
°C), arrange the vaccines, diluents and water packs in their appropriate
places.
Ø
CONDTIONING OF ICE PACKS-
Ø
Frozen ice packs,
taken directly from the freezer, are not suitable for immediate use. If they
are not correctly conditioned it is very likely that freeze-sensitive vaccines
will be frozen and destroyed.
Ø
Lay the frozen
ice packs on a work surface in a single layer leaving gaps of about 5 cm
between packs.
Ø
Wait until all
packs are properly conditioned – there must be liquid water inside every
pack and the ice-cores should move inside the packs when shaken
Ø
PACKAGING OF VACCINES IN COLD BOX AND VACCINE CARRIER-
Ø
Arrange the
conditioned ice packs or cool water packs in the cold boxes and/or vaccine
carriers exactly as shown on the manufacturer’s instructions on the inside of
the lid.
Ø
Put the vaccines
and diluents in a plastic bag in the middle of the cold box or carrier to
protect them from damage due to condensation.
Ø
If conditioned
ice packs are used, put an electronic freeze indicator with the vaccines.
Ø
For vaccine
carriers, place the foam pad in the top of the container.
Ø
Close the cold
box or vaccine carrier lid tightly.
Ø
Monitoring
Ø
Monitoring of
temperature is very important in cold chain management. A temperature
monitoring chart should be maintained at every cold chain facility by cold
chain handler. Temperatrue should be monitored and recorded at leaset two times
a day
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