Post 01020E : VACCINE OUT OF THE COLD CHAIN

POST 01020E : VACCINE OUT OF THE COLD CHAIN Follow-up on Posts 01007E and 01013E 4 December 2006 ____________________________________ This posting contains two contributions in response to Serge Ganivet's question. The first is from Souleymane Koné (mailto:[email protected]) from WHO in Geneva, and the second from Andy Tucker (mailto:[email protected]) from the United States. ____________________________________ The question raised by Serge is very relevant and right to the point. If it is possible to use the "out of the cold chain" strategy for the birth dose for a given vaccine, it is therefore possible to apply it for all other immunization for the same vaccine. WHO document "Getting started with vaccine vial monitors, WHO/V&B/02.35" (pages 7-9) concurs with this logic. Discussions are underway with PATH to refine the "out of the cold chain" strategy and define a more formal framework for its application. I thought that successful application experiences of "out of the cold chain" strategy somehow stemmed from opportunities and problems (pressing ones) to be solved. This is the case with the administration of the birth dose and some others by mass immunisation, for which the usual strategies (fixed, mobile/outreach) were obviously not of great help. Indeed to ensure the administration of a HepB vaccine dose within the first 24 hours following birth is a major challenge for many a programme, especially when the majority of deliveries take place at home. Therefore it were more sensible to have the birth dose administered by "traditional midwives" whose assistance is essential. Since extending the cold chain to homes is inconceivable (to cover the thousands of midwives scattered in villages with very little infrastructure), one can easily imagine however that it would be easier, with the help of VVM, to take the vaccine “out of the cold chainâ€