Graphic-output temperature data loggers for monitoring vaccine refrigeration: implications for pertussis.
ABSTRACT We conducted the first US study using graphic-output temperature data loggers in quantifying cold chain failure. Fifty-four vaccine refrigerators of a county outpatient health system were studied. Forty-eight percent maintained temperatures of 2°C to 8°C and 24% had protracted periods of temperatures less than 0°C. The correlation between the percentage of refrigerators with freezing temperatures and the pertussis rate for each health region was r = 0.76. The findings suggest that improper vaccine storage may have contributed to recent increases in pertussis rates.
Full-textDOI: · Available from: Patrick Mccolloster, Mar 10, 2014
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ABSTRACT: Introduction Many vaccines require a storage temperature between 2-8 °C throughout thesupply cold chain. Multiple studies conducted at healthcare facilities worldwide document an endemicfailure to properly store vaccines, risking the efficacy of local vaccination programs.This “weak link” at the end of the cold chainis largely due to both the widespread use of inadequate domestic refrigerators for vaccine storage, and electrical power interruptions. The required specialized refrigeration equipment and backup power systemareboth prohibitively expensive for smaller facilities. Prompted by this finding, the authors sought an affordable solution for small-scale vaccine storage applications. Methods The solution presented is an aftermarketappliance designed toaccompany a wide range of domestic refrigerators.After undergoing an initial calibration step, the device effectively overridesthe refrigerator's native thermostat(s) and assumes thermoregulatory control. All interfaces between the device and the refrigerator are strictly external, allowing for installation by a layperson. Wireless temperature sensor measurements are frequently logged to a removable USB thumb drive to provide vaccine temperature traceability. The device is further equipped to charge an external battery while grid power is available, and upon grid failure automatically source refrigeration power froman attached external inverter. Results The regulator device successfullymaintained a 2-8 °C environment for all properly stored vaccine vials. Furthermore, it successfully adapted to and compensated for the individual operational characteristics of various refrigerators, and flagged those unsuitable for vaccine storage. Back-up power outage resiliency is recorded at16-25 hours for 18-28ft3sized household refrigerators using a 160Ah battery.The cost of manufacturing the device is estimated at $250 per unit. Discussion The Baylor/Rice regulator device provides an affordable refrigeration control and temperature monitoring system suitable for converting household refrigerators into effective vaccine refrigerators. The device will also be useful in areas subject to electrical grid failure.Procedia in Vaccinology 01/2014; 8:89–93. DOI:10.1016/j.provac.2014.07.014
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ABSTRACT: Nicht nur angesichts der sehr häufigen Infektionen bei Kindern, sondern auch wegen des entwicklungsgemäßen kindlichen Verhaltens (Krabbeln auf dem Boden, ,,mouthing“) besteht in der kinder- und jugendärztlichen Praxis ein besonderes Risiko der Erregerübertragung, obwohl dort im Vergleich mit anderen Praxen vergleichsweise wenige invasive Maßnahmen (Blutentnahmen, Infusionen, Katheter usw.) vorgenommen werden. Eine Aufbereitung kritischer Medizinprodukte findet in Kinder- und Jugendarztpraxen praktisch überhaupt nicht statt.Sachgerechte Hygiene in kinder- und jugendärztlichen Praxen (ohne Medizinprodukteaufbereitung) setzt Folgendes voraus: ein Personal, das die Infektionsrisiken und v. a. die Übertragungswege kennt und sich entsprechend verhält, insbesondere eine gute Händehygiene und Flächendesinfektion vornimmt. Diese Maßnahmen sind nicht teuer, aber wirkungsvoll, auch bei der zunehmenden Problematik der multiresistenten Erreger. Eine gute Hygiene sicherzustellen, liegt in der Verantwortung der Praxisinhaber und Mitarbeiter selbst, zum Schutz von Patienten und Personal vor Infektionen – und nicht zuletzt auch zum Schutz vor Beschwerden oder Prozessen.Monatsschrift Kinderheilkunde 10/2013; 161(10). DOI:10.1007/s00112-013-3005-5 · 0.28 Impact Factor
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ABSTRACT: Background: Effective immunizations require a thorough, multi-step process, yet few studies comprehensively addressed issues around vaccination management. Objectives: To assess variations in vaccination management and vaccination errors in primary care. Methods: A cross sectional, web-based questionnaire survey was performed among 1157 primary physicians from North Rhine-Westphalia, Germany: a representative 10% random sample of general practitioners (n = 946) and all teaching physicians from the University Duisburg-Essen (n = 211). Four quality aspects with three items each were included: patient-related quality (patient information, patient consent, strategies to increase immunization rates), vaccine-related quality (practice vaccine spectrum, vaccine pre-selection, vaccination documentation), personnel-related quality (recommendation of vaccinations, vaccine application, personnel qualification) and storage-related quality (storage device, temperature log, vaccine storage control). For each of the four quality aspects, "good quality" was reached if all three criteria per quality aspect were fulfilled. Good vaccination management was defined as fulfilling all twelve items. Additionally, physicians' experiences with errors and nearby-errors in vaccination management were obtained. Results: More than 20% of the physicians participated in the survey. Good vaccination management was reached by 19% of the practices. Patient-related quality was good in 69% of the practices, vaccine-related quality in 73%, personnel-related quality in 59% and storage-related quality in 41% of the practices. No predictors for error reporting and good vaccination management were identified. Conclusions: We identified good results for vaccine-and patient-related quality but need to improve issues that revolve around vaccine storage.PLoS ONE 08/2014; 9(8):e105119. DOI:10.1371/journal.pone.0105119 · 3.53 Impact Factor