Protecting Refrigerated Vaccines with Water Bottles: An Evidence-Based Strategy.

ArticleinThe American journal of nursing 112(11):61-69 · November 2012with14 Reads
Impact Factor: 1.30 · DOI: 10.1097/ · Source: PubMed

A quality improvement initiative promotes safer refrigerator storage of vaccines in ambulatory clinics.

  • [Show abstract] [Hide abstract] ABSTRACT: Universal hepatitis B (HB) immunisation is the most effective means for prevention of hepatitis B virus (HBV) infection worldwide. Maintaining the vaccine cold chain is an essential part of a successful immunisation programme. Our recent nationwide survey in Mongolia has observed significant urban-rural differences in the prevalence of HBV infection among vaccinated cohorts. To examine whether the administration of HB vaccine in winter contributes to these residential discrepancies on the effectiveness of vaccination. In 2004, a nationwide serosurvey was carried out covering both urban and rural areas of Mongolia. Sampling was multistage, with random probability from all public schools in the country. A random sample of 1145 children (51.7% boys; aged 7-12 years), representative of Mongolian elementary school children. Multivariate logistic regression analysis identified that total (past and current) HBV infection (OR 2.31, 95% CI 1.20 to 4.42; p = 0.012) was independently associated with the administration of all HB vaccines in winter. An increased OR for current HBV infection was also observed (OR 2.58, 95% CI 0.87 to 7.68; p = 0.089), but without significance. Interestingly, after stratifying by residence, the association between winter vaccination and total HBV infection was evident for rural (p = 0.008) but not for urban areas (p = 0.294). The frequency of vaccine-induced immunity was significantly (p = 0.007) lower for those who received HB vaccine at birth during winter in rural areas. Administration of HB vaccine during winter is an important predictor of the low effectiveness of vaccination in rural Mongolia. To improve the effectiveness of HB vaccination in remote areas, cold chain control should be addressed with particular attention to the winter season.
    Full-text · Article · Aug 2007 · Journal of Epidemiology & Community Health
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  • [Show abstract] [Hide abstract] ABSTRACT: Millions of vaccine doses are wasted each year due to a lapse in recommended storage conditions. Maintaining the cold chain for vaccines is both expensive and difficult, especially in developing countries. The present study investigated the safety and immunogenicity of a single dose of the conjugated meningococcal Group C vaccine, Menjugate, stored for 6 months at room temperature (25+/-2 degrees C, N=250) or at 2-8 degrees C (N=250) when administered to 12-23 months toddlers. In the two respective groups, 87 and 88% of toddlers reached bactericidal antibodies titers of at least 1:8. The immunogenicity of Menjugate stored at room temperature was not inferior to that stored at 2-8 degrees C. The safety profile and immunogenicity of the vaccine was not influenced by the storage condition.
    Full-text · Article · Feb 2007 · Vaccine
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  • [Show abstract] [Hide abstract] 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-text · Article · Nov 2010 · American Journal of Public Health
    0Comments 14Citations
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