POST 00314 : VVM - DRY ICE TROUBLE? NO!

Post00314 VVM - DRY ICE TROUBLE? NO! 25 January 2001 CONTENTS 1. VVM on OPV: DRY ICE TROUBLE? NO! This discussion revolves around misinformation concerning VVMs. Fred Simiyu, WHO Nigeria, reported "Last week I heard it mentioned by a UNICEF colleague that a recent study indicates dry ice, when used to pack vaccines with VVMs, causes change in VVM colour simulating exposure to heat." Fred sent an email to Modibo Dicko, WHO/AFRO, enquiring if VVMs had a problem with dry ice exposure, and wondering if that would account for VVM changes observed in a recent oral polio vaccine shipment to one district. Hans Everts, WHO/EPI, initially responded, pointing out that the heat exposure may have occurred prior to being packed for shipment. Alissa Klopper, Lifelines Inc, the VVM company, reports on the testing of 4 production lots from different manufacturers, showing no change on exposure to dry ice - for as many as 8 days. * The answer to Fred is that the problem was that heat exposure caused the VVMs to change. Thanks to Julie Milstien, V&B/ATT and Sara Stappers, V&B/ATT, for posting the discussion. Thanks also to the Fred, Hans, and Alissa for generating a rapid clarification of puzzling field issue. Opinion, comments and additions please: [[email protected]][email protected][/email] or use your reply button ___________________________________________________________________________ From: [[email protected]][email protected][/email] To: [[email protected]][email protected][/email] Subject: FW: Dry Ice Trouble??? Date: Wed, 17 Jan 2001 10:34:51 +0100 Dear Allan, Please find below details of correspondence regarding a problem with VVMs in Nigeria. Julie Milstien asked me to contact Lifelines Technology Inc. for their response, which I have enclosed here. Dr Milstien also asked me to request that this information is posted to Technet, I would be very grateful if you would do this for us. Please don't hesitate to let me know if you should need any further information. Best regards, Sara Stappers Sara Stappers Secretary ATT, V&B World Health Organization Tel. (41) 22 791 2051 Fax (41) 22 791 4384 ___________________________________________________________________________ Subject: Dry Ice Trouble??? Author: "Fred Simiyu" Date: 11/29/00 10:26 PM Dear Modibo, Last week I heard it mentioned by a UNICEF colleague that a recent study indicates dry ice, when used to pack vaccines with VVMs, causes change in VVM colour simulating exposure to heat. Probably a chemical result of the sublimation process? Is anyone out there aware of this study? Is it documented? During the just concluded R2 of NIDs, OPV was transported to one of our States, Anambra. NIDs OPV was packed with dry ice while routine OPV was packed with conventional ice packs. All the OPVC had VVMs at stage 1 on departure. The truck had some trouble on the way and arrived over 15 hrs later. On arrival, all OPV for NIDs were at VVM 2 while that for routine was at VVM 1. Another factor that could have caused this was that the routine OPV was packed with more ice packs than that for NIDs due to a number of reasons that we have since addressed here. Could it also have been 'dry ice trouble'? Regards, Fred. --- From: [[email protected]][email protected][/email] Sent: 02 December 2000 11:45 To: Fred Simiyu Subject: Re:Dry Ice Trouble??? Hi Fred! I don't have an off-the-shelf answer to this question and if Hans does not either, then it would be good to set up a small experiment scientifically organized. What do you think? Modibo --- Subject: RE: Dry Ice Trouble??? Author: evertsj at whohq6 Date: 04/12/2000 16:09 Interesting problem. I do not know of studies regarding the effect of dry ice on VVM. Even with a complete breakdown of the cold chain, if the vaccine was packed properly from the start and if the VVM were at 1, the VVM should only slightly have started to change colour. Even though all VVM looked like being at step 1, they may have had different heat exposure before that. In the beginning the difference in colour may not be very obvious. Do you know when the batches arrived and where they were stored. Hans Everts Technical Officer EPI WHO Geneva Tel: 00 41 22 791 3683 --- From: [[email protected]][email protected][/email] Sent: Monday, 4 December 2000 Subject: RE: Dry Ice Trouble??? Sara, could you please forward to Ted Prusik, Lifelines, for response ___________________________________________________________________________ * TEXT OF LIFELINES TECHNOLOGY INC. RESPONSE ___________________________________________________________________________ LifeLines Technology, Inc. 116 American Rd. Morris Plains, NJ 07950 USA Tel: (973) 984-6000 Fax: (973) 984-1520 January 2, 2001 TO: Sara Stappers CC: J. Milstein, T. Prusik Dear Ms. Stappers, Tests have been conducted on four lots (different manufacturers) of OPV VVMs to verify that dry ice has no effect on the reactivity of VVMs. The table below shows that the OD does not change during six days of frozen storage with dry ice, blue ice packs, or in a conventional freezer. OD(reference) - OD(indicator) Lot Number Days of Storage Blue ice packs Dry ice -30C freezer JG343/1 0 0.37 0.37 0.37 2.1 0.36 0.36 0.37 5.8 0.37 0.37 0.37 JG286/1 0 0.32 0.32 0.32 2.1 0.33 0.32 0.33 5.8 0.33 0.33 0.33 JG358/1 0 0.35 0.35 0.35 2.1 0.35 0.35 0.35 5.8 0.36 0.36 0.36 JG349/1 0 0.35 0.35 0.35 2.1 0.35 0.35 0.35 5.8 0.35 0.36 0.36 Our conclusion is that the OD issue identified in Anambra is not due to dry ice. Sincerely, Alissa Klopper QA Manager ____________________________________*______________________________________