The document describes 4 photographs taken during a vaccine store assessment in Fiji in 2003. The photographs show a shake test being conducted on 2 vials, with one vial as a control that was purposely frozen solid, while the other test vial had not been affected by freezing. Over the course of several minutes, the photographs demonstrate that the unfrozen test vial sediments slower than the frozen control vial, indicating it passed the shake test and could be safely used.

1. The following 4 photographs were taken on 6 August 2003 in Suva, Fiji during the primary vaccine store assessment (Richard Duncan (WPRO) and Diana Chang-Blanc (PATH) on the background). The shake test See the difference in sedimentation rates Umit Kartoglu In principle, you do not need to wait this long. The moment you are confident that you can tell whether the sedimentation rates are different or same in two vials, you may end the test. Resolution of digital images in this presentation is purposely reduced for having smaller file size Control vial (purposely frozen) The demonstration was conducted with 10 dose TT vaccine. For better visualization, the labels are scrubbed off. The control vial (on the left) was purposely frozen solid at -25 o C for 4 hours. Test vial (passes the test : not affected by freezing) In this demonstration, the test vial on the right sediments slower compared to the control vial: The test vial has not been affected by freezing, and may be used safely.

2. 10:25 am 4 minutes after placing the vials on the table

3. 10:28 am

4. 10:31 am

5. 10:33 am