The cold chain is a system used to store and transport vaccines at the proper temperatures from manufacturers to recipients. It includes cold chain equipment like walk-in cold rooms, deep freezers, ice-lined refrigerators, cold boxes, vaccine carriers, and day carriers. Proper cold chain storage and transportation is crucial because some vaccines like polio and measles must be kept at very cold temperatures to maintain their efficacy. Nurses play an important role in maintaining the cold chain by arranging and transporting vaccines safely using the appropriate equipment and temperatures.

2. Introduction:
 The cold chain is a system of storage, transport and
distribution of vaccines in the state of efficiency and
potency at recommended temperature from the
Manufacturer to the actual recipient of the vaccine.
 The cold chain system is necessary

3. ELEMENTS OF COLD CHAIN
 Cold chain equipment
 Transportation system
 Motivation of training of the workers for maintance of cold chain
link
 Polio is the most sensitive vaccine it storage at
– 20c
 Polio and measles vaccines must be stored in the freezer
compartment
 DTP, DT,BCG,TT,typhoid vaccine must be stored in the cold part
 Polio can be stored at 4 to 8c for 5 wks

4. THE COLD CHAIN EQUIPMENT
WALK IN COLD ROOMS:
They are located at regional level vaccines are stored at 3 months and serve 4-5
districts
DEEP FREEZERS :
 It is a top opening cold chain equipment .
 Big deep freezers is supplied all district . They are used for
making ice packs and store for storing polio and measles
 Small deep freezers along with ILR are supplied to PHCs urban family planning,
centers
ICE LINED REFRIGERATOR (ILR) :
Two types of ILR are available first one is ice tubes and other with ice packs

5.  ILR should kept in cool room, away from direct sunlight and at
least 10cm away from the wall
 The vaccines should be kept in side the ILR neatly with space in
between for air circulation
COLD BOXES:
 Cold boxes are available at all peripheral health centers . They
are used for transporting vaccines
 The vaccines should be packed in polythene bags then to be kept
in side the box
 DTP,DT ,TT vaccines should not be kept in contact with frozen
ice packs

6. VACCINE CARRIERS:
 Vaccine carriers are used to carry to 16 to 20 vials of
vaccine to out reach sites to the subcenters,viallage,
vaccination clinic or camp.
 The carrier must be closed tightly.
DAY CARRIERS:
 Day carriers are used for near by areas and for few
hours period.
 It is used small quantities of vaccines

7. ICE PACKS:
 Ice packs are used for cold boxes and vaccines carriers.
 It is prepared in the deep freezer
 Ice packs contains water filled up to the level

8. NURSES RESPONSIBILITES:
 The community health nurse have to play major role in
maintaining cold chain.
 Arrangement and maintained required amount of
vaccines.
 Maintained of cold chain system at immunization
center or during transportation of vaccines to home or
clinics with necessary precautions.
 Care of cold chain equipments and maintenance of
recommended temperature for vaccines.