Format

Send to:

Choose Destination
See comment in PubMed Commons below
Bull World Health Organ. 2004 Feb;82(2):99-105. Epub 2004 Mar 16.

Hepatitis B vaccine freezing in the Indonesian cold chain: evidence and solutions.

Author information

  • 1Program for Appropriate Technology in Health, Seattle, WA 98107, USA. cnelson@path.org

Abstract

OBJECTIVES:

To document and characterize freezing temperatures in the Indonesian vaccine cold chain and to evaluate the feasibility of changes designed to reduce the occurrence of freezing.

METHODS:

Data loggers were used to measure temperatures of shipments of hepatitis B vaccine from manufacturer to point of use. Baseline conditions and three intervention phases were monitored. During each of the intervention phases, vaccines were removed progressively from the standard 2-8 degrees C cold chain.

FINDINGS:

Freezing temperatures were recorded in 75% of baseline shipments. The highest rates of freezing occurred during transport from province to district, storage in district-level ice-lined refrigerators, and storage in refrigerators in health centres. Interventions reduced freezing, without excessive heat exposure.

CONCLUSIONS:

Inadvertent freezing of freeze-sensitive vaccines is widespread in Indonesia. Simple strategies exist to reduce freezing - for example, selective transport and storage of vaccines at ambient temperatures. The use of vaccine vial monitors reduces the risk associated with heat-damaged vaccines in these scenarios. Policy changes that allow limited storage of freeze-sensitive vaccines at temperatures >2-8 degrees C would enable flexible vaccine distribution strategies that could reduce vaccine freezing, reduce costs, and increase capacity.

PMID:
15042231
[PubMed - indexed for MEDLINE]
PMCID:
PMC2585906
Free PMC Article
PubMed Commons home

PubMed Commons

0 comments
How to join PubMed Commons

    Supplemental Content

    Full text links

    Icon for Scientific Electronic Library Online Icon for PubMed Central
    Loading ...
    Write to the Help Desk