Cold chain in vaccination in english

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1. By – SURESH KUMAR ( Nursing Tutor ) TO WATCH THIS SLIDE WITH VOICE EXPALINATION AS VIDEO PLEASE VISIT MY YOUTUBE CHANNEL “MY STUDENT SUPPORT SYSTEM”

2. COLD CHAIN “ cold chain” is a system to maintain vaccine quality from the time of manufacture until the point of administration by ensuring that vaccines are stored and transported within the recommended temperature ranges.

3. COLD CHAIN The system used for storing vaccines in good condition is called the cold chain. It is sometimes referred to as the vaccine supply chain, or the immunization supply chain. The cold chain consists of a series of links that are designed to keep vaccines within the recommended temperature ranges, from the point of manufacture to the point of administration

4. COLD CHAIN

5. Why cold chain? Excessive heat or cold exposure damages vaccine, resulting in loss of potency. Once potency is lost, it can never be restored. Furthermore, each time vaccine is exposed to heat or cold, the loss of potency increases and eventually, if the cold chain is not correctly maintained, all potency will be lost, and the vaccine becomes useless.

6. Essential elements : Cold chain Personnel to manage vaccine distribution Equipment for vaccine storage & transport Maintenance of equipment Monitoring

7. Personnel to manage vaccine distribution There should be a designated and trained personnel (cold chain handler) in handling cold chain and distribution of vaccines at all levels including center, state, district and all health facilities of cold chain equipment and vaccine distribution .

8. Equipment for vaccine storage & transport Cold chain equipments includes- Walk in coolers Deep freezer Ice-Lined Refrigerator (ILR) Cold Box Refrigerator Vaccine carrier Ice pack

9. Walk-in coolers These are big equipments of cold chain system like a room. These are used at regional level vaccine storage system. Temperature range 0-25 degree can be maintained in these coolers. These are also known as walk in cold rooms.

10. Deep freezer Deep freezer is used at district and CHC level. A temperature range of -20 to 25 degree can be maintained in deep freezers. It is used to store polio vaccine and to freeze ice packs.

11. Ice lined refrigerator Ice lined refrigerator (ILR) is used at approximately all the vaccine storage facilities. A temperature range of 2-8 degree in maintained in ILR.

12. Cold Box It is a thermo-insulator box which is used to transport vaccines. freezed ice packs are placed at bottom, sides and top of vaccines to be transported inside the cod box.

13. Refrigerator It is a simple refrigerator and used at PHC or sub-center level to maintain cold chain for vaccines. WHO recommended refrigerator is slightly different form domestic refrigerator.

14. Vaccine carrier It is also a thermo-insulator box having strips to carry at the point of vaccination. 4 ice packs are kept inside to maintain recommended temperature to vaccines.

15. Ice packs It is plastic box which is filled with water and freezed in deep freezer. After freezing these are used in cold boxes and vaccine carriers to keep vaccines cold.

16. Maintenance of cold chain equipments All cold chain equipments should be well maintained. They should have dedicated switch board for electrical supply.Cold chain handler should take care to defrost the electrical equipments (deep fridge, ILR and refrigerator ) regularly as and when needed. Do not let ice deposition more than 0.5 cm thick

17. Defrosting of cold chain equipments Remove all the vaccines and transfer them to another refrigerator or to a cold box or vaccine carrier lined with conditioned ice packs. Switch off the electrical supply for the ILR/refrigerator . Leave the door open and wait for the ice to melt. Never try to remove the ice with a knife or ice pick; this can permanently damage the ILR/refrigerator . A pan of boiling water can be placed inside and the door closed.

18. Defrosting of cold chain equipments Clean the inside of the ILR/refrigerator and door seal with a clean damp cloth. Re-start the ILR/refrigerator . Do not adjust the thermostat. When the temperature in the main section falls to +8 °C or lower (but not less than +2 °C), arrange the vaccines, diluents and water packs in their appropriate places.

19. Conditioning of Ice Packs Frozen ice packs, taken directly from the freezer, are not suitable for immediate use. If they are not correctly conditioned it is very likely that freeze-sensitive vaccines will be frozen and destroyed . Lay the frozen ice packs on a work surface in a single layer leaving gaps of about 5 cm between packs. Wait until all packs are properly conditioned – there must be liquid water inside every pack and the ice-cores should move inside the packs when shaken

20. Packing vaccines in cold boxes and vaccine carriers Arrange the conditioned ice packs or cool water packs in the cold boxes and/or vaccine carriers exactly as shown on the manufacturer’s instructions on the inside of the lid. Put the vaccines and diluents in a plastic bag in the middle of the cold box or carrier to protect them from damage due to condensation.

21. Packing vaccines in cold boxes and vaccine carriers If conditioned ice packs are used, put an electronic freeze indicator with the vaccines. For vaccine carriers, place the foam pad in the top of the container. Close the cold box or vaccine carrier lid tightly.

22. Arranging cold Box arranging vaccine carrier

23. Monitoring Monitoring of temperature is very important in cold chain management. A temperature monitoring chart should be maintained at every cold chain facility by cold chain handler. Temperatrue should be monitored and recorded at leaset two times a day

24. Temperature monitoring devices.

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