COLD CHAIN Dr Anuj.pptx

VACCINE COLD CHAN

1. The Cold Chain System Dr. Anuj Singh Asst. Professor Community Medicine Dept. UIMS, Prayagraj

2. Immunization is the most effective method of preventing childhood diseases India has largest UIP in the world Under UIP children are protected against 6 vaccine preventable diseases. Background

3. Six Vaccine preventable diseases: Diphtheria Pertussis 3. Tetanus 4. Poliomyelitis 5. Measles 6. Pulmonary tuberculosis

4. Immunization is delivered through: District Hospital Community health centers (CHC) Primary health centers (PHC) Aganwadi centers

5. Vaccines are sensitive biological products. Some vaccines are sensitive to freezing , some to heat and others to light. Vaccine potency: meaning its ability to adequately protect the vaccinated patient , which can be diminish when the vaccine is exposed to inappropriate temperatures. Once lost, vaccine potency cannot be regained . A vaccine must have 2 characteristics: i.e. Safety and Potency

6. The success of national immunization programme is highly dependant on supply chain system for delivery of vaccines and equipment, with a functional system that meets 6 rights of supply chain The right vaccine in the right quantity at the right place at the right time in the right condition (no temperature breaks in cold chain) and at the right cost

7. Cold Chain

8. 1.Walk in freezer It maintains a temperature between - 15°C to - 25°C. WIF are usually installed at national, state and regional vaccine stores. It is used for bulk storage of OPV vaccine and for preparation of frozen ice packs for vaccine transportation.

9. 2.Walk in cooler These Walk-in-coolers are installed at government medical store depots, state and regional vaccine stores. Maintain a temperature of +2°C to +8°C. used for storage of large quantities of all UIP vaccines

10. 3. Deep freezer (DF) The cabinet temperature maintained between -15° to - 25°C. Used for storing of OPV for 3 months (district level and above only) and also for freezing of ice packs (at sub-district level only). Unlike ILR, the DF has or limited hold-over time which is dependent on the number of frozen ice packs in it and the frequency of lid opening.

11. 4. Ice lined refrigerator (ILR) Most important link in the cold chain is ice lined refrigerator (ILR). ILRs maintain temperature between +2°C to + 8°C Used to store vaccines at district and sub-district level. Holdover time: 24-hrs after 8hrs of continuous power supply.

12. Hold-over time of the equipment In the event of power failure , hold-over time is defined as the "time taken by the equipment to raise the inside cabinet temperature from its temperature at the time of power cut, to maximum temperature limit of its recommended range.” E.g. in case of ILR if the cabinet temperature is +4°C at the time of power-cut, then the time taken to reach +8°C from +4°C will be hold-over time for that ILR.

13. Ambient temperature: More the ambient temperature less will be the hold-over time; Frequency of opening of lid and use of basket; (c) Quantity of vaccines kept inside with adequate space between the containers (Equipment empty/loaded); (d) Condition of ice-pack lining (Frozen/partially frozen/melted). Hold-over time depends on the following factors :

14. Domestic refrigerator (front load refrigerator) Domestic refrigerators can also maintain the temperature between +2°C to +8°C, but the hold-over time and capacity to store vaccines/ freeze icepacks is limited . They can be used for storage of vaccine at private clinics and nursing homes, provided continuous power supply is ensured.

15. Temperature charting