Cold chain system

1. Prof.Nagamani.T

2. Introduction
Vaccination is an effective public
health measure to prevent and
control a number of infectious
diseases.

3. A vaccine is a biological product. If
it gets too hot or too cold, the active
ingredients can degrade and
become less effective.

4. Once a dose of vaccine is manufactured,
it needs to be transported to
immunization programs and clinics and
health centers all over the world, and
then remain viable until it’s needed.
This process often referred to as the
'cold-chain'.

5. A high-quality cold chain allows
health workers to deliver life-saving
vaccines to every last child.

6. The term cold chain, or cool chain, denotes
the series of actions and equipment
applied to maintain a product within a
specified low-temperature range from
harvest/production to consumption.

7. Definition
A Cold chain is a system of storage and
transportation of vaccines at
recommended low temperatures from the
time and place of manufacturer to the
actual time and vaccination usage site.
Manufacturer Distributor
Vaccine
depots
Provider
office
Consumer

8. The temperature ranges between +2°C
and +8°C with a target +5°C, does not
allow for refreezing or storage at room
temperature.

9. Importance of cold chain
An uninterrupted cold chain provides a
safe, temperature-controlled environment
for sensitive items such as fresh and
frozen food produce, pharmaceutical
products, biologics, chemicals, and
vaccines.

10. Risks of a break in the cold chain
the risk of microbial growth,
 the appearance of germs such as
salmonella or
a reduction of the shelf life of the
product
Different types of health risks

11. Cold chain equipment
Different levels within the health care
system need different equipment for
transporting and storing vaccines and
diluents at the correct temperatures.
Health facilities: need refrigerators with
freezing compartments, cold boxes and
vaccine carrier

12. Cold chain equipment
Refrigerators
Walk in cold (WIC) rooms
Cold boxes
Vaccine carrier
Day carrier
Ice packs/Cold packs

13. Refrigerators
Refrigerators must be selected carefully and used properly.
They must be:
 able to maintain the required storage temperatures
through all seasons;
 large enough to hold the year’s highest monthly
inventory, including influenza season;
 equipped with a calibrated min/max thermometer or
data logger;
 dedicated to storing only vaccines and biologics; and
 in a secure location away from unauthorized personnel
and public access.

14. Types of Refrigerators
Deep freezers (300 ltr):
 Deep freezer is a top opening equipment. It
is used to store polio and measles vaccine
and freezing of icepacks.
 They maintain temperature between -15oC
to -25oC
 In case of power failure, they can maintain
the cabinet temperature for about 18-22
hours.

15. Ice lined refrigerator (ILR):
 ILR is also a top opening equipment, and two
types are in use. One with ice tubes
(electrolux), and the other with ice packs
(vestfrost) as the ice lining.
 All vaccines at PHC level can be stored in the
ILR.
 They can maintain the temperature between
+2oC to +8oC

16. Small deep freezers ( 140 Ltr):
 One set is provide to PHCs, Urban family
planning centers and post partum centers.
 Deep freezers are used to prepare frozed ice
packs which are used in cold boxes, vaccine
carriers for transportation of vaccines and
during the sessions.

17. Walk in Cold (WIC) rooms
 Walk in Cold (WIC) rooms are typically used at the
central and regional level for storage of vaccines.
 They meant to store vaccines upto 3 months and serve
4-5 districts.
 All types of vaccines can be stored safely for a long
time even if there is interruption in power supply.

18. Cold boxes
 Cold boxes are supplied to all subcentres and
peripheral areas.
 Cold boxes are means to collect, store and transport
large quantities of vaccine by vehicle to out reach sites.
 They are specially constructed boxes with thick sides,
bottom and top and filled with insulation material.
 Place fully frozen ice pack at the bottom and sides,
before placing vaccines in the cold boxes.

19.  The vaccines are kept in carton or polythene bags.
 The vials of DPT, DT, TT vaccines and diluents should
not be places in direct contact with the frozen ice pack.
 Before using cold box, ensure that it is clean and the
lid is closed tightly and has locks.
 If the cold packs start melting and the temperature
gets close to +8o C, immediately replace with fresh
frozen ice pack.

20. Vaccine carrier
 Vaccine carriers are insulated containers,
when lined with coolant packs, keep
vaccines and diluents cold during
transportation.
 They are smaller than cold boxes and are
easier to carry when walking.
 They are used for transporting vaccines
from health facilities with refrigeration to
outreach sessions where refrigeration and
ice are not available.

21.  They are typically carried by a single health worker
travelling on foot or by other means, where the
combined journey time and immunization activity
ranges from a few hours to a whole day.
 The vaccine storage capacity of vaccine carriers are
between 0.1 and 5.0 litres.

22. Day carrier
 They are small boxes made of insulated material.
 Day carriers are used to carry small quantities of
vaccines ( 6-8 vials) to a near by session.
 Two fully frozen packs should be used to line these
boxes.
 They are used only for a few hours.

23. Ice packs/Cold packs
 A water-pack frozen to a temperature between -5°C
and -20°C before use. Ice-packs are used frozen for the
transport of oral polio vaccine (OPV), and used
conditioned (see procedure for conditioning further
down) for the transport of all other vaccines.

25. Instructions
 Vaccine temperature must be maintained as per the
recommendations of the manufacturer and stability of
the vaccine.
 Temperature must be monitored frequently to prevent
denaturation of the vaccine.
 C4- The complete care cold chain must be maintained
for all vaccines.
 Among all, polio is the most sensitive to heat, requires
storage at minus 20oC.

26.  Vaccines to store in freezer compartments are; Polio,
Measles.
 Vaccines that are stored in the cold cart but never
allowed to freeze are; Typhoid, DPT, TT, DT, Hepatitis
B, BCG, and other diluents.
 Vaccines must not be exposed to sunlight.

27.  Opened multi dose vaccine vials which have not fully
used must be discarded with in one hour, or if no
preservative is present within 3 hours or at the end of
the session if preservative is present.
 All used vials should be sent back to the PHC after the
session is over on the same day.

28. THANK YOU