Cold Chain

Surveillance Coordinator

Provincial EPI cell

What is cold chain system

• From the manufacture to the recipient, all the steps n people involved in keeping the vaccine in the required temperature is called the cold chain system

The cold chain

• Vaccines are sensitive biological.• Needs special attention.• Damages by heat – freezing.• Once potency is lost – cannot be regained.• Requires special storage mechanism.• From manufacturer to site of use.• Two major factors.

» Staff» Equipment

Current vaccine management system

EPI cold rooms

• Peshawar.

• Malakand.

• Mansehra.

• Kohat.

• Bannu.

• D.I.Khan.

Location of cold rooms

Vaccine storage

• Ideal temperature (2 to 8 ) so that pneumococcal, penta & TT do not freeze

• Polio if needed to be stored for more then 3 months can be stored in – 20.

• Thermometers– Dial, cold chain monitor card, mercury

• VVM, Shake test

Conclusion.

• Good installations are available.• Have trained staff posted.• Have the vaccine storage capacity for entire

divisions.• Working back up is available in most of the cold

rooms.• Stock registered are maintained.

Conclusion-2

• Cold rooms remained out of order for considerable time.

• No mechanism for local repair.• No allocation for POL of generators.• Did not serve during the past 2 years.• No proper supervision mechanism of concerned

staff.

• No leave account maintained.• No written job description of staff.• Not trained on storekeeping.

Conclusion-3

• No procedures for• Receiving vaccines.• Issuing vaccines. (vit A during NIDs)

• No proper vaccine management system. (Frequency & quantity of vaccine)

• Vaccine is collected from provincial cold room instead of divisional.

• Divisional cold rooms are under utilized.• No allocation for maintenance and repair.

Suggestions

• Much more is desired to be done.• Vaccine management system.

• Date of collection – vaccine stock at different levels.

• Regular review/signing of stock registers.• Mechanism for monitoring of the system.• Development of SOPs for various tasks.• Using checklists for various occasions.

Suggestions-2

• Ensuring vaccine stock at every level.• Collection of vaccine from divisional, instead of

provincial cold room.• Allocation of maintenance and repair funds beyond

the PC-1 period.• POL issue for generators to be taken.

Suggestions-3

• Training of personnel on storekeeping practices.• Installation of automatic temperature recording

equipment.• Developing mechanism for utilization of technical

staff.• Provincial cell should deliver vaccine to cold rooms.

Proposed vaccine management system

• Vaccine should be collected from federal cell on quarterly basis.

• Provincial store to supply vaccine to cold rooms.• Divisional cold room have 3 months quota.• Districts will collect vaccine from divisional cold

rooms.• District stores – 2 months supply.• EPI centers – 1 month stock.

Checklist for receiving vaccine

• When Vaccine Consignments Arrive at the Storage Point :

• All details of the consignment must be checked.• All detail be recorded in the stock register. • District • Name of cold room/store/health facility• Name of storekeeper/worker• Designation

– The type of vaccine • The quantity received (in doses) • The vaccine manufacturer • The batch or lot number. • The expiry date. • The status of the VVM• Balance

Issuing vaccine

• Record of each consignment leaving the store is appropriate.

• All details should be recorded.– The quantity issued.– Batch number.– Expiry dates .– To whom issued.– The remaining balance.

While vaccine is in storage• All vaccines must be systematically arranged .• Older stock should normally be distributed first.

(FIFO).• Expiry must be checked regularly.• All stocks must be distributed well before their

expiry date.• Ensure that no batch or lot remains too long in

storage.• Regularly check the integrity of the stocks by

reviewing the status of VVM.• Any expired, damaged or vials with VVMs beyond

the discard point should not appear in the stock balance.

• Vaccine demand– Requirement/Target.– Vaccine in balance.– Consumption in previous month (s)– Vaccine received in previous month.– Vaccine issued.– Vaccination coverage.

Thank you