Vaccine Cold Chain

1. Cold Chain

2. What is the Cold Chain?
The Cold Chain is the system of:
that keeps vaccines at the right temperature during
storage and transportation from the point of manufacture to
the point of use.
People
Equipment
Procedures
.

3. Cold
Why have the Cold Chain?
If vaccines are exposed to excessive
they may lose their potency or effectiveness.
Heat
Light

4. HEAT DAMAGE
• Heat damage is cumulative effect
• Reconstituted vaccine is most
sensitive to heat and light.
• Measles and BCG vaccines should not
be used 4 hrs after reconstitution and
JE 2 hrs after reconstitution
• Temperature of diluents & vaccine
must be same during reconstitution

5. Heat sensitivity
• BCG (after reconstitution)
• OPV
• Measles (before and after
reconstitution)
• DPT
• BCG (before reconstitution)
• TT
• HepB
LEAST SENSITIVE
MOST SENSITIVE

6. Electrical Cold Chain
Equipment

7. Tirunelveli
(3 Dts)
Madurai
(6 Dts)
Coimbatore
(4 Dts)
Thanjavur
(3 Dts)
Tiruchy
(4 Dts)
Salem
(4 Dts)
Vellore
(2 Dts)
Chennai
(3 Dts)
Cuddalore
(2 Dts)
Walk in cooler Regions in
Tamil Nadu-
10 Nos

8. Walk-in-Cooler ( WIC )
• Prefabricated cold room used
for storage of bulk vaccines at
State & Regional stores.
• Storage temperatures: (+) 2°C
to(+) 8°C,
• Two identical cooling units
and power backup generator.
• Alarm and hooter system.
• Used to store all UIP vaccines Walk-in Cooler

9. Walk-in-Freezer ( WIF)
• Prefabricated freezers for
National/State/Regional stores.
• Storage temperatures (-)15 to
(-) 25°C.
• Two identical cooling units and
power backup generator.
• Alarm and hooter system.
• Used to store bulk quantity of
OPV & freeze ice packs Walk-in Freezer

10. Deep Freezer (DF)
• Top opening lid
• Cabinet temperature -15 to -25oC
• Used for storing of OPV (district level and
above only) and also for freezing ice
packs.
Holdover time : 26 hours at 32 o C

11. Freezing Ice-packs in the Deep Freezer
Never store
UIP
vaccines in
the DF.
Use only for
freezing
icepacks
Large compartment
Wipe dry and
arrange 20-25
unfrozen icepacks
vertically (never flat)
in a crisscross
pattern with space
Un-frozen
icepacks for
freezing
Store frozen
icepacks only
up to half the
height of the
large
compartment
Small
compartment
Arrange and
store frozen
icepacks
vertically, in
layers.
Also store in cold
boxes

12. Deep Freezer

14. Ice-Lined Refrigerator (ILR)
It is a top opening refrigerator for better
holding of cool air
• ILR- Model MK 304 - vaccine storage
capacity 108 liters or 26000 to 30000
doses of mixed antigen
• ILR- Model MK 144 - vaccine storage
capacity 45 liters or 11000 to 13000 doses
of mixed antigen
• ILR- Model HBC 200 - vaccine storage
capacity 100 liters or 24000 to 28000
doses of mixed antigen
• ILR- Model HBC 70- vaccine storage
capacity 50 liters or 12000 to 14000 doses
of mixed antigen
* OPV for 1 month only. Store in DF if longer than a month

15. OPV
DPT
DPT
DPT
DPT
DT
DT
Diluent Diluent Diluent
TT TT TT
TT
DPT
Measles Measles
Measles
OPV
OPV OPV
Measles
Measles Measles
Measles
Measles Measles
OPV OPV
OPV
BCG BCG BCG
TT
DPT
DPT
DPT
Measles
DPT
Hep B
Hep B
DTT
DPT
DPT
DPT DPT DPT
DT
TT
BCG
BCG
BCG
TT TT TT
DT
DT
DT
Hep B Hep B
Hep B Hep B Hep B
BCG BCG
DPT Diluent
Diluent
Diluent
Diluent
Keep thermometer hanging
position in basket and
maintain temperature
between
+2O C to +8O C (monitor
morning and evening)
Arrange
vaccines in order
(top to bottom)
Hep B
DPT, DT, TT
BCG
Measles
OPV
Follow Early
Expiry First Out
(EEFO)
Discard
any frozen
Hep B,
DPT, TT
and DT
Store all
vaccines in
baskets
Store
diluents in
baskets, for
24 hours
before next
session
Keep
space
between
boxes
Storing vaccines in the Ice-Lined
Refrigerator

16. Diluents vials must NEVER be frozen.
Vaccines GMSD State/Divisional/District Primary Health
centre
Sub-Centres
OPV -15°C to -25°C
+2°C to +8°C
BCG
+2°C to +8°C
Measles
Hep B
DPT
TT
The correct storage temperatures

17. Non Electrical Cold Chain
Equipment

18. Non- Electrical Cold
Chain Equipment

19. Cold Boxes
• Used for transportation of vaccines
• Store vaccines and icepacks in
emergency
• The hold over time is 90 hours for 5
litre and six days for 20 litre cold box
at + 43oC ambient temperature, if the
cold box is not opened at all
• Place conditioned ice-packs at the
bottom and sides before loading
vaccines.
• Keep a thermometer inside the cold
box.
X

20. Vaccine carriers
• Used for carrying vaccines (16-20
vials) and diluents from PHC to the
outreach session sites.
• With 4 conditioned icepacks
maintain inside temperature of 2-80C
for 12 hours.
• Close the lid of the carrier tightly.
• Never use any day carriers with 2
icepacks or thermos flask for
carrying vaccines.

21. CONDITIONING
• On the session day, take
the frozen ice-packs you
need from the freezer
and place on a table
• Allow ice-packs to sweat
at room temperature for
some time
• Shake the ice pack to
listen to melted for
water.
A Conditioned an ice-pack

22. Vaccine Vial Monitor (VVM)
Usable VVM Stages Unusable VVM Stages
Discard Point :
The color of the inner square
matches that of outer circle:
Do not use the vaccine.
If the color of the inner square
is darker than the outer circle,
Do not use the vaccine