Uganda
Japan
Yellow fever
Typhoid
Tetanus
TB
Rotavirus
Rabies
Japanese encephalitis
Influenza
HPV
Hepatitis B
Hepatitis A
Cholera
Vaccine management
Temperature Monitoring Study To Commence in Vietnam and Uganda
by Joanie Robertson, Huong Vu and James Cheyne, PATH
While some vaccines will lose their potency if they are stored at temperatures above or below the standard 2° to 8°C, many vaccines are quite heat stable and can tolerate temperatures up to 40°C for months without spoiling. Allowing these relatively heat-stable vaccines to spend time outside of refrigeration for controlled periods of time could facilitate some outreach strategies and might free up valuable space in the vaccine cold chain. See Table 1.
Table 1: Vaccines licensed for storage at 2° to 8°C...despite stability[1]
Storage at up to 40°C
Vaccine
Formulation
1-2 months
Japanese encephalitis (inactivated)
Rotavirus
Bacillus Calmette-Guérin
Cholera (WC/rCTB)*
Haemophilus influenzae type b
Yellow Fever
Current, liquid
Spray-dried
Spray-dried
Liquid
Current, liquid
Lyophilized
2-6 months
Influenza
Diptheria
HPV
Meningitis A conjugate
Rabies
Tetanus
Spray-dried
Current, liquid
Current, liquid
Spray-dried
Lyophilized
Current, liquid
≥6 months
Hepatitis A
Hepatitis B
Typhoid (live)
Current, liquid
Spray-dried
Vacuum-drie
* WC/rCTB= recombinant cholera toxin, b-subunit.
To better understand the parameters of a future supply chain for vaccines that does not require full-time refrigeration, Optimize is supporting two studies, one in Vietnam and another in Uganda, to gather ambient temperature data in multiple geographic settings and seasons as part of ongoing Human Papillomavirus (HPV) vaccine delivery demonstration projects. When compiled, these data will provide a set of real temperatures during real vaccine sessions that would serve as examples of the type of conditions that vaccines might be exposed to if they were out of the cold chain, ultimately adding to the discussion on future supply chain policies that dictate how vaccines are stored and transported within a country.
In the study, small temperature recording deviceswill be attached at the district-level Expanded Programme on Immunization (EPI) offices to the interior and exterior of vaccine cold boxes when vaccine is picked up for transport by commune-level health staff for delivery in schools and community health facilities. The temperature recorders will be kept with the vaccines at all times until the cold boxes are returned to the district level. The person in charge of these vaccines will document the date, time, and location of each place that the vaccine is stored and delivered. When the vaccine sessions are over, the recorders will be removed and returned to the PATH office for download and analysis in collaboration with the local Ministries of Health.
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[1]Table extracted from ‘Optimizing vaccine supply chains,’ June 2009, Joanie Roberston (PATH), Carol Levin (PATH), Michel Zaffran, (WHO)
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