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Cold Chain.pptx

The document discusses the importance of maintaining an uninterrupted cold chain for transporting and storing vaccines. It defines a cold chain as a system used to keep vaccines within a temperature range of 2-8°C from the time of manufacturing to the point of administration. Breaks in the cold chain can allow microbial growth and reduce vaccine effectiveness. Various equipment is used at different levels of the healthcare system to ensure vaccines remain at the proper cold temperatures, including refrigerators, freezers, cold boxes, vaccine carriers, and ice or cold packs. Precisely monitoring and maintaining vaccine temperatures is crucial for preserving their stability and potency.

Health & Medicine◦
Prof.Nagamani.T
Introduction Vaccination is an effective public health measure to prevent and control a number of infectious diseases.
A vaccine is a biological product. If it gets too hot or too cold, the active ingredients can degrade and become less effective.
Once a dose of vaccine is manufactured, it needs to be transported to immunization programs and clinics and health centers all over the world, and then remain viable until it’s needed. This process often referred to as the 'cold-chain'.
A high-quality cold chain allows health workers to deliver life-saving vaccines to every last child.
The term cold chain, or cool chain, denotes the series of actions and equipment applied to maintain a product within a specified low-temperature range from harvest/production to consumption.
Definition A Cold chain is a system of storage and transportation of vaccines at recommended low temperatures from the time and place of manufacturer to the actual time and vaccination usage site. Manufacturer Distributor Vaccine depots Provider office Consumer
The temperature ranges between +2°C and +8°C with a target +5°C, does not allow for refreezing or storage at room temperature.
Importance of cold chain An uninterrupted cold chain provides a safe, temperature-controlled environment for sensitive items such as fresh and frozen food produce, pharmaceutical products, biologics, chemicals, and vaccines.
Risks of a break in the cold chain the risk of microbial growth,  the appearance of germs such as salmonella or a reduction of the shelf life of the product Different types of health risks
Cold chain equipment Different levels within the health care system need different equipment for transporting and storing vaccines and diluents at the correct temperatures. Health facilities: need refrigerators with freezing compartments, cold boxes and vaccine carrier
Cold chain equipment Refrigerators Walk in cold (WIC) rooms Cold boxes Vaccine carrier Day carrier Ice packs/Cold packs
Refrigerators Refrigerators must be selected carefully and used properly. They must be:  able to maintain the required storage temperatures through all seasons;  large enough to hold the year’s highest monthly inventory, including influenza season;  equipped with a calibrated min/max thermometer or data logger;  dedicated to storing only vaccines and biologics; and  in a secure location away from unauthorized personnel and public access.
Types of Refrigerators Deep freezers (300 ltr):  Deep freezer is a top opening equipment. It is used to store polio and measles vaccine and freezing of icepacks.  They maintain temperature between -15oC to -25oC  In case of power failure, they can maintain the cabinet temperature for about 18-22 hours.
Ice lined refrigerator (ILR):  ILR is also a top opening equipment, and two types are in use. One with ice tubes (electrolux), and the other with ice packs (vestfrost) as the ice lining.  All vaccines at PHC level can be stored in the ILR.  They can maintain the temperature between +2oC to +8oC
Small deep freezers ( 140 Ltr):  One set is provide to PHCs, Urban family planning centers and post partum centers.  Deep freezers are used to prepare frozed ice packs which are used in cold boxes, vaccine carriers for transportation of vaccines and during the sessions.
Walk in Cold (WIC) rooms  Walk in Cold (WIC) rooms are typically used at the central and regional level for storage of vaccines.  They meant to store vaccines upto 3 months and serve 4-5 districts.  All types of vaccines can be stored safely for a long time even if there is interruption in power supply.
Cold boxes  Cold boxes are supplied to all subcentres and peripheral areas.  Cold boxes are means to collect, store and transport large quantities of vaccine by vehicle to out reach sites.  They are specially constructed boxes with thick sides, bottom and top and filled with insulation material.  Place fully frozen ice pack at the bottom and sides, before placing vaccines in the cold boxes.
 The vaccines are kept in carton or polythene bags.  The vials of DPT, DT, TT vaccines and diluents should not be places in direct contact with the frozen ice pack.  Before using cold box, ensure that it is clean and the lid is closed tightly and has locks.  If the cold packs start melting and the temperature gets close to +8o C, immediately replace with fresh frozen ice pack.
Vaccine carrier  Vaccine carriers are insulated containers, when lined with coolant packs, keep vaccines and diluents cold during transportation.  They are smaller than cold boxes and are easier to carry when walking.  They are used for transporting vaccines from health facilities with refrigeration to outreach sessions where refrigeration and ice are not available.
 They are typically carried by a single health worker travelling on foot or by other means, where the combined journey time and immunization activity ranges from a few hours to a whole day.  The vaccine storage capacity of vaccine carriers are between 0.1 and 5.0 litres.
Day carrier  They are small boxes made of insulated material.  Day carriers are used to carry small quantities of vaccines ( 6-8 vials) to a near by session.  Two fully frozen packs should be used to line these boxes.  They are used only for a few hours.
Ice packs/Cold packs  A water-pack frozen to a temperature between -5°C and -20°C before use. Ice-packs are used frozen for the transport of oral polio vaccine (OPV), and used conditioned (see procedure for conditioning further down) for the transport of all other vaccines.
Instructions  Vaccine temperature must be maintained as per the recommendations of the manufacturer and stability of the vaccine.  Temperature must be monitored frequently to prevent denaturation of the vaccine.  C4- The complete care cold chain must be maintained for all vaccines.  Among all, polio is the most sensitive to heat, requires storage at minus 20oC.
 Vaccines to store in freezer compartments are; Polio, Measles.  Vaccines that are stored in the cold cart but never allowed to freeze are; Typhoid, DPT, TT, DT, Hepatitis B, BCG, and other diluents.  Vaccines must not be exposed to sunlight.
 Opened multi dose vaccine vials which have not fully used must be discarded with in one hour, or if no preservative is present within 3 hours or at the end of the session if preservative is present.  All used vials should be sent back to the PHC after the session is over on the same day.
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