POST 01235E: VACCINE FREEZE-PREVENTION AIDE MEMOIRE—CORREC

POST 01235E: VACCINE FREEZE-PREVENTION AIDE MEMOIRE—CORRECTIONS 5 MARCH 2008 ******************************************* Dear Moderator, I've just read the new aide-memoire on vaccine freezing (WHO/IVB/07.09) and have some comments on what I think is a rather flawed document. During domestic transport: -" Use cool-water packs instead of ice-packs" No indication is given of the desired temperature for the packs. From the wording there is no way to tell how this procedure should be carried out and how the temperature of the water in the pack should be checked. - "Use no ice-packs ......." This statement could easily be misinterpreted as a general recommendation to omit any form of cooling medium (ice-packs or cool-water packs) during 'domestic transport' (which is how I initially read it). If it is only referring to the very specific operational context set out in 'Getting started with vaccine vial monitors', it requires a separate, clearly labelled box, with all the caveats contained in the reference document. In vaccine cold rooms: No mention is made of the EVSM recommendation for continuous temperature monitoring, which has been mandatory in the E01 cold room specifications since at least 2002 (Ref: WHO/V&B/02.33) and was included as an option in every 'Outline specifications for vaccine cold store' since the 1986–87 first edition of the Product Information Sheets. This is a serious omission. During EVSM evaluations, I am still seeing national vaccine stores without continuous temperature monitoring equipment. This is no longer acceptable. In refrigerators: - "Put a freeze indicator in every refrigerator at the level where the freeze-sensitive vaccines are stored." There is no such "level". You can put it in the basket where the vaccine is stored, but where in the basket? At the top of the load where you can read it, or buried in the load where you cannot? - "Place the thermometer in the coldest part of the refrigerator: at the bottom of a top-loading chest refrigerator." How do you read it if it is at the bottom? And is this the bottom of the basket, or the bottom of the refrigerator? - "Set the thermostat to 5ËšC in the morning ................" The wording implies you have to do this every day whereas I assume that the Aide-Memoire intends this to be a once-only operation. In any case, you can't set a thermostat to 5ËšC unless it is directly calibrated in degrees. This is not the case—instead you have to set the thermostat by reference to a thermometer. So this is a much more complex operation than the wording suggests. It ought to be re-written. In cold climates: - "Keep cold rooms and vaccine refrigerators in heated rooms.â€