Cold Revolution

You're right of course!! - what are the two pdf documents in your post? I can't access them.

Hello Ian, The two files look at domestic refrigerators and compare them with Vaccine Safe, a locally designed refrigerator for vaccines. I am reattaching the files. Hope you can access them now. Cold-revolutionP1.pdf Cold-revolutionP2.pdf

Potent vaccine has to be administered to 'IMMUNIZE' the vaccinated for which keeping the vaccines at required temperature is very essential. Details are in the Post. Cold-revolution-2.pdf

Posted on behalf of William Msirikale Use of domestic refrigerators for storage of vaccines in India is not recommended. Domestic refrigerators are difficult to be modified for safe vaccine storage. They are: – designed and built for food and drink storage; – do not have particularly accurate temperature controlling systems; – can have notable temperature variations within one compartment; – Cabinet temperature can be easily affected by room temperature; it is not easy to maintain the temperature between +2C to +8C. If you want to have potent vaccine, use vaccines which do not have too much temperature fluctuations to avoid vaccine spoiled by low of high temperature. I advise the private clinics in India to use the refrigerators which have already been recommended by WHO and UNICEF, which have already tested and been recommended for vaccine storage. William Msirikale Cold Chain and Logistics Officer EPI-Ministry of Health and Social welfare Tanzania.

Sir Thanks for sharing. On Tue, Jul 12, 2011 at 10:37 PM, TechNet21 wrote:

Hello William, You are of course correct. It must be understood that refrigerators have 3 cycles to regulate their temperature. One cycle is when the system is in cooling mode which has the evaporator temperatures around -26C. Then an off mode and finally a defrost mode which actually heats the evaporator to melt any ice build up. As a result standard refrigerators have dramatic variations in temperature during the course of a day. Also standard refrigerators are generally poorly insulated which increases the variation in temperature within the refrigerator. It is not uncommon to experience freezing temperatures in one location (near the evaporator) and temperatures above 10C on the door. As a result items such as vaccines stored in such equipment will typically be subject to variations in temperatures outside the safe and desired ranges.

Dear Madam Thanks, the link could not open. I wish to know more about the equipment.

Here is the link: http://www.technet21.org/index.php/documents/view-document-details/1137-true_energy_vaccine_refrigerator.html

Dear Cath, Saw the equipment. I am very familiar with top lid Ice lined refrigerator of 70 liter, 140 liter and 300 liter (round figures) all have almost same cabinet height but different side to side width, with baskets placed in two rows, built in thermal sensor at the mid-level facilitating digital temperature display outside the cabinet. In addition a dial/stem thermometer is placed inside which is recorded daily twice at about 10 AM and 4 PM. Recently data-logger is also made available for monitoring continuously. When the dedicated Cold-chain handler operates there will be minimal 'thermal disturbance' to the vaccines. Each basket is also covered with large blue ice-pack with thermal buffer so that mixing-up of hot room air with the cool air in the cabin will be minimal. However there is one disadvantage of having two rows of baskets because to remove the vaccines from the bottom basket the upper basket has to be exposed to room temperature for a short period of a few seconds to a long period of a couple of minutes. But thermal assault mainly refers to sudden exposure to range beyond 2 to 8 both direction and such sudden exposure may escape VVM radar as its limitation which is meant for monitoring in the natural way. This is avoided in the 'Vaccine Safe' as it has only one zone. Coming to the model with vertical door, the cool air of the cabinet being heavy easily mixes with the room air which is usually more than 22 degree, usually around 30 with diurnal variation unless and until the room is air conditioned (as in some Pvt Clinics). Endurance to heat varies from antigen to antigen depending upon their heat sensitivity (hence VVM 2 to VVM30). Each rack is not separately protected. External display of the temperature if facilitated where will be the location of sensor/at what level to keep the dial/stem thermometer or is data-logger facility available? In our country nonavailability of the equipment is an important factor from my experience in the last 2 decades, they are willing to procure at an affordable price. They too need a range of equipment from 10 liter to 100 liter {something like nano to Mercedes} approximate round figure, as many wants to vaccinate in their clinic. Since single dose antigens are available they have to open as and when the beneficiary comes (cafeteria). Main distributes will have an entirely different story. As you said and I am dreaming for the last 12 years a real "REVOLUTION" is required. I can only hope for the better.

Dear Cath Thanks for the response.