The document provides information on various vaccines used in the Expanded Program on Immunization (EPI), including storage requirements, administration details, contraindications and side effects. It discusses the Bacille Calmette-Guérin (BCG) vaccine, Oral Polio Vaccine (OPV), Pentavalent vaccine, Measles vaccine, and Rotavirus vaccine. It also covers the strategy for vaccine delivery, components of the cold chain like equipment and tools for monitoring temperature, and factors that can damage vaccines.
Cold Chain The ‘cold chain’ is the system of transporting and storing vaccines at recommended temperature from the point of manufacture to the point of use. Manufacturer Distributor Vaccine Depots Provider office Client.
Cold Chain The ‘cold chain’ is the system of transporting and storing vaccines at recommended temperature from the point of manufacture to the point of use. Manufacturer Distributor Vaccine Depots Provider office Client.
Cold Chain System & Proper Vaccination By Rajesh Das.pptxRajesh Das
Cold Chain Logistics & Management. Cold Chain System and Proper Immunization Schedule in INDIA. Safe Vaccination is build our immune system and protect us from disease. Polio is a dangerous disease we can safe from polio by taking Polio Vaccine. Also we can safe from many disease by taking vaccine. To store, To Transport, To Distribute need a system by maintaining proper temperature which is Cold Chain.
It commonly institutes activities that limit risk exposure or increase the immunity of individuals at risk to prevent a disease from progressing in a susceptible individual to subclinical disease. For example, immunizations are a form of primary prevention.
mmunization currently prevents 3.5-5 million deaths every year from diseases like diphtheria, tetanus, pertussis, influenza and measles. Immunization is a key component of primary health care and an indisputable human right. It's also one of the best health investments money can buy.
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It commonly institutes activities that limit risk exposure or increase the immunity of individuals at risk to prevent a disease from progressing in a susceptible individual to subclinical disease. For example, immunizations are a form of primary prevention.
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2. Bacille Calmette-Guérin (BCG)
Vaccine:
Live attenuated vaccine
Store at 0° to 8°C
Age : at birth or 6 weeks
Route of administration:
a single intra dermal injection over the deltoid
muscle of the arm or left forearm .
3.
4. At site of injection: development of erythema
and either a papule or ulceration, followed by a
scar at the immunization site.
5. Bacille Calmette-Guérin (BCG) Vaccine:
Side effects:
Lymphadenitis
Contraindication:
Immune deficiency diseases, including congenital
immunodeficiency, HIV infection and impaired immune
function secondary to treatment with corticosteroids,
chemotherapeutic agents or radiation.
6. ORAL POLIO VACCINE (OPV)
Contents: Sabin attenuated polio virus (live
attenuated vaccine)
Ideal age of Initiating primary vaccination:
6 week
(an additional dose recommended at birth by
W.H.O. OPV0)
7. ORAL POLIO VACCINE (OPV)
Boosters: Two, at 1.5 years and between 4-5
years.
Dose: 2 drops.
Route of administration: Oral.
8. ORAL POLIO VACCINE (OPV)
Contra – Indications:
Immunocompromised host or household
member.
Side effects: None.
Complications: Vaccine induced
poliomyelites (one in 3 million vaccine)
The dose of OPV given during an episode of
diarrhea should not be counted and shoud
be to given at the earliest opportunity
11. Pentavalent Vaccine
Contents: Each 0.5 ml contains:
Diphtheria toxoid, Tetanus toxoid, pertussis,
Hepatitis B, Haemophilus influenzae b.
The vaccine should not kept frozen or exposed to
freezing
Store at 2° to 8°C
Dose: 0.5 ml.
12. Pentavalent Vaccine
Route of administration: Deep intramuscular.
Site of administration: Anterolateral aspect of
thigh.
13. Pentavalent Vaccine
Side effects: Fever, local pain and swelling.
Instruction to the mother after vaccination:
To give antipyretic (paracetamol) in case of
fever.
16. Measles Vaccines
Contents: live attenuated measles virus grow in chick
embryo cells.
Store at 0 to 8°C
Ideal age of Primary vaccination:
9 months.
In epidemics & household contacts should be between
6-9 months
17. Measles Vaccines
Dose: 0.5 ml.
Route of administration: Subcutaneous.
Site of administration: Upper arm or anterolateral aspect of
thigh.
.
18. Measles
Side effects: : Mild fever & rash may appear
after 5-7 days.
Contra-Indications:
Immuno compromised host.
Severe (anaphylactic) egg allergy.
19. Rotavirus Vaccines
Contains one strain of live attenuated
rotavirus (type G1P[8]
Store at (2-8
o
C) and protect from light
20. Rotavirus Vaccine
Dose: 1.5 ml
2 doses
minimum interval between doses is 4 week
Age:-
beginning at 6weeks of age
Early immunization is favoured with the first dose of rotavirus vaccine to
be administered from
6 weeks of age, however, in order to benefit those who may come late
infants can receive doses
without age restriction. Because of the typical age distribution of rotavirus
gastroenteritis
( rotavirus vaccination of children >24 months of age is not recommended.
25. Contraindications to live attenuated vaccines:
Absolute:
1- History of anaphylactic reactions.
2- Subsequent doses of pertussis vaccines are absolutely
contraindicated if the child gets (within 48 hours of vaccination )
• Fever (40.5º) ,
•Collapse or shock .
•Persistent crying for 3 hours without apparent cause.
•Convulsion with or without fever within 3 hours after
vaccination.
Give a single dose vaccine of diphtheria + tetanus pediatric formula
( avoid pertussis component).
26. Contraindications to live attenuated vaccines:
Absolute:
3- HIV infection is an absolute contraindication to administration of
live attenuated vaccines ( OPV & BCG).
27. Temporary:
1- Severe illness that needs hospitalization.
Deferred immunization till the infant recovers and could
be at discharge.
2- Immunosuppression.
29. The strategy for the vaccine delivery:
(I) The fixed site strategy.
(II)Outreach site strategy.
(III) Mopping up Immunization.
(IV)The National Immunization Days (NIDs).
30. 1. The fixed site strategy:
There is integration of immunization services through (MCH):
Advantages:-
1-Available resources.
2- Cold Chain maintenance.
3- Save ,time, effort and money.
31. 2.The out reach Strategy
The outreach is carried for routine immunization that is compulsory
for the targets in certain areas where:
- immunization services are not accessible.
- vaccination coverage is Low.
Limitations:
(i) Expensive
(ii) Cold chain failure.
(iii) Difficulty to arrange the immunization schedule.
34. (3) Mopping up Immunization:
• It is house-to-house immunization with OPV in high risk districts.
• High risk districts are those:
• Where the wild polio virus is still circulating
• With low immunization coverage.
• Population, with overcrowding poor sanitary environment
and low access to health services.
35. (4) The National Immunization Days (NIDs):
It is periodic immunization of all the eligible targets in a defined
group over a large geographic areas within a short period of time. It
is one of the strategy for polio eradication and tetanus elimination.
37. The cold chain:
It is the system of storage and transportation of the
vaccine at low temperature (cold condition) from the
manufacture till it is consumed.
38. The cold chain:
• Polio vaccine is the most sensitive vaccine to heat.
• Live attenuated vaccines are allowed to be frozen (OPV,
Measles and BCG).
• Inactivated vaccines must not be frozen ( DPT, DT, dT , TT
and HB) .
40. The administrative
level
Storage
period
Temperature The vaccines
Central & regional
stores
Maximum
three months
- 20° to- 30°C
OPV, Measles,
MMR,BCG
+2° to +8°C DPT, DT, dT,
TT& HB,Hib
Districts stores&
local immunization
centers
Maximum
one month
0°C to+8°C
OPV, Measles,
MMR, BCG
+2° to +8°C DPT, DT, dT,
TT& HB,Hib
The administrative levels of cold chain according to the
duration of the storage and the temperature required to keep
the vaccine potent
41. The equipment and tools
The procedures
The health staff
The components of the cold chain :
42. Refrigeration equipment:
Refrigerator
Cold boxes
Vaccine carriers
The ice packs retained in the freezer
-To stabilize the temperature of the refrigerator at the
optimum level.
- Fully frozen ice-packs are used for lining the vaccines
carriers and the cold boxes during storing the vaccines
43. Cold Chain Equipment
The recommended
equipment typically
used for vaccine storage
are :
cold rooms,
refrigerators and
freezers.
For transporting vaccines
equipment such as
cold boxes,
vaccine carriers and
49. The refrigerator :
• Placed in the coolest place of the health centers away from sunlight
• Well ventilated and adequate air circulation around it .
• Kept locked and open only when necessary.
•Ice packs are kept in the freezer.
• Its temperature is recorded twice daily.
• Both the monitor and thermometer are placed in the refrigerator.
• The temperature chart is stuck on the door outside the refrigerator.
• The diluents should be kept on the lowest shelf.
• Drugs, drinks or food must not be stored in the refrigerator
52. Tools for monitoring the cold chain:
1- Cold Chain Monitor Card.
2- Freeze Watch Indicator
3- Cold Chain Refrigerator Graph
4- Vaccine Vial Monitors
5- Shake Test
53. Cold Chain Refrigerator Graph
The vaccines are stored in refrigerators, they are monitored twice a day
and readings are recorded on a chart to ensure a safe temperature is
maintained
+2°C
+8°C
54. 2-Cold Chain Monitor
Card: is used to show
cumulative exposure to
Temp. above the safe
range during storage&
transportation.
56. 3-Vaccine vial monitors:
Every vial is also shipped with a
temperature-sensitive label, that health
workers monitor during vaccination
sessions.
57. SAFE
If the inner square is
lighter than the outer
ring and the expiration
date is valid, the
vaccine is
usable
SPOILED
If the inner square
matches or is darker
than the outer ring,
the vaccine must be
discarded.
58. 4-The shake test
DPT, hepatitis B and
tetanus toxoid vaccines
can all be damaged by
freezing. By shaking two
vials, side-by-side, one
that might have been
frozen and one that has
never been frozen, health
workers can determine if a
vaccine has spoiled.
59. What damage the Vaccines?
1. Any defect in the cold chain.
2. Out date expiry.
3. Exposure of the vaccine to unacceptable temperature
during the immunization session.
4. Exposure of the vaccine to direct sunlight (BCG)