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COLD CHAIN
DR.ANJALATCHI MUTHUKUMARAN
VICE PRINCIPAL
ERA COLLEGE OF NURSING
ERA UNIVERSITY
INTRODUCTION
 Cold chain is the system used for storing vaccine in good
condition. It is otherwise called a vaccine supply chain or
immunization supply chain. It is a series of links that are
designed to keep vaccines with WHO-recommended Temperature
Ranges from the point of manufacture to the point of
immunization. The cold chain system is necessary because
vaccine failure may occur due to failure to store and transport
under the strict temperature.
 The term supply chain management was first coined by Keith
Oliver.
DEFINITION
The “Cold Chain” is a system
of storage and transport of
vaccine at low temperature
from the manufacturer to actual
vaccination site
COLD CHAIN PPT.pptx

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COLD CHAIN
• System of storage & transport of vaccines at low temp. from
the manufacturer to the actual vaccination site.
Manufacturer
Airpor
t State/Region
District
store Health centre
Outreach
Subcentre
IMPORTANCE OF COLD
CHAIN
 Obtaining the vaccine from
manufacturers.
 Storing and transporting the vaccine
 Maintaining the supply of vaccine
 Having information about essential
equipments ,supply of electricity etc
 Keeping the vaccine at low temperature
 Protecting the vaccine from sunlight
exposure
TRANSPORT AND STORAGE
For successful Cold chain system, three elements are essential:
 Personnel: To manage vaccine storage and Distribution.
 Equipments: To store and Transport vaccine and to monitor
temperature.
 Procedures: To ensure the vaccines are stored and transport at
appropriate temperature.
 All the vaccine must be stored, transported and distributed at
the recommend temperature by the manufacturer in the
literature accompanying the vaccine , otherwise they may
become denatured and totally in effective with loss of potency
CONT….
 Among all vaccine , polio is the most heat sensitive,
requiring storage at 20.C
 Polio and measles vaccines must be stored in the
freezer comportment
 TPD, DT, TT, BCG Typhoid and diluents of vaccines
must be stored in the cold part and never allow to
freeze
 Vaccine must be protected from sunlight and contact
of antiseptic

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COLD CHAIN
EQUIPMENTS
 Walk in cold room : they are
located at regional level , meant to
store vaccines up to three months
and serve 4-5 district.
Walk-in-Freezers
(WIF)
 Installed in all of the states and larger divisional head
quarters.
 They maintain a temperature around -20°C.
 bulk storage of OPV, and also to prepare frozen ice packs
at state stores.
Available in
sizes of 16.5 Cum.
and 32 Cum.
Deep Freezers: supplied to all districts and PHC to store vaccines
the cabinet temperature is maintained between 15.C -25.C in case of
power failure , these freezers can maintain the cabinet temperature
for 18-22 hours. Deep
Freezer are used polio and measles vaccines. 300ltr - 140ltr
for making ice packs and for storing capacity available in
deep freezer.
CONT…
Ice lined refrigerator: -
 ILR are kept at the PHC and district level. The cabinet temperature is maintain at
+2.C to +8.C at the PHC level, ILR are used for storing all UIP Vaccines.
 The bottom of ILR is the coldest part. DPT, DT, TT and diluents should not be kept
directly on the floor of the ILR as they can freeze and get denatured. These vaccines
should be kept in the basket provided within the ILR.
 Temperature of the ILR should be recorded twice a day with the dial thermometer
which should be kept inside the ILR, even if there is an in built thermometer.

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COLD CHAIN PPT.pptx
CONT…
There are some DOs and DONTs for the use of ILR
freezer.
 DOs: keep the equipment in cool room away from
direct sunlight and at least 10cms away from the
walls. The vaccine should be kept inside the ILR
neatly with the space in between for air circulation.
The ILR should be kept locked and open only when
necessary.
 DONTs: do not kept any object on the deep freezer or
ILR. Never store any other Drugs. Drinking water,
foods or date expired vaccines or more then 1 month
requirement at PHCs level and don’t open these
equipment unless required.
CONT..
Cold Boxes:
 cold boxes are available at all peripheral health
centers. They are used for transporting vaccines and
also for storing vaccines during failure of electric
supply. Fully frozen ice packs are placed at the
bottom and sides of the cold box before placing the
vaccines in it. The vaccines should be first packed in
cartoons or polythene bags then to be kept inside the
cold box. DPT, DT, TT vaccines and diluents should
not be kept in direct contract with the frozen ice
packs.
COLD BOXES

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CONT…
Vaccines carrier :
 vaccines carrier are used to carry 16 to 20
vials of vaccines to out Reach sites to the Sub
centers, village vaccination clinics or camp.
Four fully frozen ice packs are placed for
lining the sides of the carriers DPT, DT,TT
and diluents should not be placed in direct
contract of frozen ice packs. The carrier must
be closed tightly. 4 ice packs cantains in the
vaccine carriers.
VACCINE CARRIER
CONT..
Day Carriers:
 Day carriers are used for nearby areas and only for
few hours period with two fully frozen ice packs. It is
used to carry small quantities of Vaccines, e.g. 6 to 8
vials only.
CONT…
Ice Packs:
 Ice packs are used for cold boxes and vaccines
Carriers. it is prepared in the deep freezer. Ice
Pack Contain water, filed up to the level
market on the side. No salt is added to it leak
ice pack should not be used.

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CORRECT STORAGE
AND USE OF DILUENTS
 Only use the diluents supplied and
packaged by the manufacturer with the
vaccine since the diluents is specially
designed for the needs of that vaccine, with
respect to volume, PH level and chemical
properties.
 Store the diluents between +20C to +80C in
the ILR. If there are store the diluents
between +20C to +80C in the ILR.
CONT…
 If there are constants of space, than store diluents
outside the cold chain. However, remember to cool
diluents for at least 24 hours before use to ensure that
vaccine and diluents are at 20C to 8oC when being
reconstituted. Otherwise, it can lead to thermal shock
i.e the death of some or all the essential live
organisms in the vaccine.
 Store the Diluents and droppers with the vaccines in
the vaccine carriers during transportation .Diluents
should not come in direct contact with the ice pack.
MONITOR AND CONTROL OF
TEMPERATURE:-
Should be a Routine Activity.
At the start and end of each working day
Monitoring devices include:
 Thermometers.
 Temperature record sheets.
 Refrigerator and freezer thermostat.
 Cold chain monitoring card (CCM)
 Vaccine vial monitoring(VVM)
 Freeze watch indicator.
CONT…
 Thermometer: every piece of cold chain should be fitted with a thermometer.
 Different types may be used, commonly mercury thermometer. i.e Dial
thermometer ,Stem thermometer
 Temperature record sheets: Record temperature of refrigerator or freezer.
 Twice Daily: in the morning and afternoon. Any malfunction then should be
reported.
 Refrigerator or Freeze thermostat: Used to control storage Temperature.
 Thermostat is set to suitable temperature.

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This document discusses the importance of maintaining a cold chain for vaccines in India's Universal Immunization Program. It explains that vaccines must be stored and transported within a specific temperature range to maintain potency. The cold chain involves a system using equipment like walk-in freezers, walk-in coolers, ice-lined refrigerators, deep freezers, cold boxes, and vaccine carriers to store and transport vaccines from manufacturers to immunization sites while keeping them within the proper temperature range. Proper cold chain maintenance is critical to ensure vaccine safety and efficacy.

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The cold chain is a system used to store and transport vaccines between 2-8°C from manufacture to point of use. It consists of personnel to manage distribution, equipment like walk-in freezers and coolers to store vaccines, and procedures to ensure proper temperature. Vaccines are transported using cold boxes, vaccine carriers, and ice packs to maintain the cold temperature as they move through various levels like national stores, district stores, PHCs, and outreach sessions. A vaccine vial monitor indicates acceptable heat exposure and the reverse cold chain transports specimens back to testing laboratories.

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COLD CHAIN PPT.pptx
COLD CHAIN PPT.pptx
VACCINE VIAL MONITOR(VVM)
A VVM is a label containing a heat – sensitive material
which is Placed on a vaccine vial to register
cumulative heat exposure over time .
 Reading the stage of the VVM:-
 Stage 2: The inner square is lighter then the outer
Circle. if the expiry date has not been passed :use the
vaccine
 Stage 2: The inner square is still lighter than the
outer Circle. if the expiry date has not been passed
:use the vaccine

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THIS SLIDE IS PREPARED BY SURESH KUMAR FOR MY STUDENT SUPPORT SYSTEM TO WATCH THIS VIDEO VISIT YOUTUBE CHANNEL- Important links- youtube channel https://www.youtube.com/c/MYSTUDENTSUPPORTSYSTEM facebook profile- https://www.facebook.com/suresh.kr.lrhs/ FACEBOOK PAGE- https://www.facebook.com/My-Student-Support-System-101733164924592 facebook group NURSING NOTES- https://www.facebook.com/groups/241390897133057/ FOR MAKING EASY NOTES YOU CAN ALSO VISIT MY BLOG – BLOGGER- https://mynursingstudents.blogspot.com/ Instagram- https://www.instagram.com/mystudentsupportsystem_nursing/ Twitter- https://twitter.com/student_system?s=08 #coldchain,#vaccination,#vaccines,#immunity,#acquiredimmunity,#innateimmunity,#activeimmunity, #passiveimmuniyt,#childhealthnursing#anm,#gnm,#bscnursing

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Cold Chain for Vaccine
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This document discusses India's Universal Immunization Programme (UIP) and the importance of maintaining a proper cold chain for vaccine storage and transport. It outlines the key components of India's cold chain system, including walk-in freezers, walk-in coolers, deep freezers, ice-lined refrigerators, cold boxes, and vaccine carriers. It describes how each component works and its role in storing vaccines at different levels of the healthcare system from national to sub-center, as well as proper procedures for packing vaccine carriers and maintaining temperatures.

cold chain for vaccine immunization vaccination va
Cold chain
Cold chain Cold chain
Cold chain

This document discusses India's Universal Immunization Programme (UIP) and the importance of maintaining a proper cold chain for vaccine storage and transport. It outlines the key components of India's cold chain system, including walk-in freezers, walk-in coolers, deep freezers, ice-lined refrigerators, cold boxes, and vaccine carriers. It describes how each component works and its role in storing or transporting vaccines at the appropriate temperatures from national to sub-center levels to ensure vaccine potency. Maintaining an unbroken cold chain is essential for effective immunization.

cold chainimmunizationvaccination
CONT…
Discard Point :
 Stage 3: The color of the inner square matches that of
the outer circle : Don’t use the vaccine
Beyond the discard point
 Stage 4: The color of the inner square is darker than
the outer Circle. Don’t use the Vaccine.
 The VVM does not directly measure vaccine potency
but gives information about the main factor that
affects potency i.e Heat exposure over a period of
time.
USABLE A N D UNUSABLE STAGES OF
VVM
COLD CHAIN PPT.pptx
THANK
YOU

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The document discusses guidelines for maintaining an effective cold chain system for storing and transporting vaccines. It outlines key aspects of cold chain management including: - Proper arrangement of vaccines in the refrigerator by type and expiration date - Monitoring refrigerator temperature twice daily and recording readings - Appropriately packing vaccines in cold boxes with ice packs during transportation - Procedures for reconstituting vaccines and conducting shake tests to check for freezing damage - Steps to take if a breach in the cold chain occurs, such as separating affected vaccines and communicating details to experts The cold chain is critical for ensuring vaccines remain potent and effective for immunization programs.

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vvmcold chain monitoring equipment:cold chain equipments
Cold Chain and it's equipment & monitoring
Cold Chain and it's equipment & monitoringCold Chain and it's equipment & monitoring
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A cold chain is a temperature-controlled supply chain that involves the storage, transportation and distribution of perishable goods such as vaccine. A high-quality cold chain allows health workers to deliver life-saving vaccines to every last child. It includes all the equipment which is used for storage at required temperature and supply to health workers safely. There are various types for cool box & refrigerator for store the vaccine according to required temperature.

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COLD CHAIN PPT.pptx

  • 1. COLD CHAIN DR.ANJALATCHI MUTHUKUMARAN VICE PRINCIPAL ERA COLLEGE OF NURSING ERA UNIVERSITY
  • 2. INTRODUCTION  Cold chain is the system used for storing vaccine in good condition. It is otherwise called a vaccine supply chain or immunization supply chain. It is a series of links that are designed to keep vaccines with WHO-recommended Temperature Ranges from the point of manufacture to the point of immunization. The cold chain system is necessary because vaccine failure may occur due to failure to store and transport under the strict temperature.  The term supply chain management was first coined by Keith Oliver.
  • 3. DEFINITION The “Cold Chain” is a system of storage and transport of vaccine at low temperature from the manufacturer to actual vaccination site
  • 5. COLD CHAIN • System of storage & transport of vaccines at low temp. from the manufacturer to the actual vaccination site. Manufacturer Airpor t State/Region District store Health centre Outreach Subcentre
  • 6. IMPORTANCE OF COLD CHAIN  Obtaining the vaccine from manufacturers.  Storing and transporting the vaccine  Maintaining the supply of vaccine  Having information about essential equipments ,supply of electricity etc  Keeping the vaccine at low temperature  Protecting the vaccine from sunlight exposure
  • 7. TRANSPORT AND STORAGE For successful Cold chain system, three elements are essential:  Personnel: To manage vaccine storage and Distribution.  Equipments: To store and Transport vaccine and to monitor temperature.  Procedures: To ensure the vaccines are stored and transport at appropriate temperature.  All the vaccine must be stored, transported and distributed at the recommend temperature by the manufacturer in the literature accompanying the vaccine , otherwise they may become denatured and totally in effective with loss of potency
  • 8. CONT….  Among all vaccine , polio is the most heat sensitive, requiring storage at 20.C  Polio and measles vaccines must be stored in the freezer comportment  TPD, DT, TT, BCG Typhoid and diluents of vaccines must be stored in the cold part and never allow to freeze  Vaccine must be protected from sunlight and contact of antiseptic
  • 9. COLD CHAIN EQUIPMENTS  Walk in cold room : they are located at regional level , meant to store vaccines up to three months and serve 4-5 district.
  • 10. Walk-in-Freezers (WIF)  Installed in all of the states and larger divisional head quarters.  They maintain a temperature around -20°C.  bulk storage of OPV, and also to prepare frozen ice packs at state stores. Available in sizes of 16.5 Cum. and 32 Cum.
  • 11. Deep Freezers: supplied to all districts and PHC to store vaccines the cabinet temperature is maintained between 15.C -25.C in case of power failure , these freezers can maintain the cabinet temperature for 18-22 hours. Deep Freezer are used polio and measles vaccines. 300ltr - 140ltr for making ice packs and for storing capacity available in deep freezer.
  • 12. CONT… Ice lined refrigerator: -  ILR are kept at the PHC and district level. The cabinet temperature is maintain at +2.C to +8.C at the PHC level, ILR are used for storing all UIP Vaccines.  The bottom of ILR is the coldest part. DPT, DT, TT and diluents should not be kept directly on the floor of the ILR as they can freeze and get denatured. These vaccines should be kept in the basket provided within the ILR.  Temperature of the ILR should be recorded twice a day with the dial thermometer which should be kept inside the ILR, even if there is an in built thermometer.
  • 14. CONT… There are some DOs and DONTs for the use of ILR freezer.  DOs: keep the equipment in cool room away from direct sunlight and at least 10cms away from the walls. The vaccine should be kept inside the ILR neatly with the space in between for air circulation. The ILR should be kept locked and open only when necessary.  DONTs: do not kept any object on the deep freezer or ILR. Never store any other Drugs. Drinking water, foods or date expired vaccines or more then 1 month requirement at PHCs level and don’t open these equipment unless required.
  • 15. CONT.. Cold Boxes:  cold boxes are available at all peripheral health centers. They are used for transporting vaccines and also for storing vaccines during failure of electric supply. Fully frozen ice packs are placed at the bottom and sides of the cold box before placing the vaccines in it. The vaccines should be first packed in cartoons or polythene bags then to be kept inside the cold box. DPT, DT, TT vaccines and diluents should not be kept in direct contract with the frozen ice packs.
  • 17. CONT… Vaccines carrier :  vaccines carrier are used to carry 16 to 20 vials of vaccines to out Reach sites to the Sub centers, village vaccination clinics or camp. Four fully frozen ice packs are placed for lining the sides of the carriers DPT, DT,TT and diluents should not be placed in direct contract of frozen ice packs. The carrier must be closed tightly. 4 ice packs cantains in the vaccine carriers.
  • 19. CONT.. Day Carriers:  Day carriers are used for nearby areas and only for few hours period with two fully frozen ice packs. It is used to carry small quantities of Vaccines, e.g. 6 to 8 vials only.
  • 20. CONT… Ice Packs:  Ice packs are used for cold boxes and vaccines Carriers. it is prepared in the deep freezer. Ice Pack Contain water, filed up to the level market on the side. No salt is added to it leak ice pack should not be used.
  • 21. CORRECT STORAGE AND USE OF DILUENTS  Only use the diluents supplied and packaged by the manufacturer with the vaccine since the diluents is specially designed for the needs of that vaccine, with respect to volume, PH level and chemical properties.  Store the diluents between +20C to +80C in the ILR. If there are store the diluents between +20C to +80C in the ILR.
  • 22. CONT…  If there are constants of space, than store diluents outside the cold chain. However, remember to cool diluents for at least 24 hours before use to ensure that vaccine and diluents are at 20C to 8oC when being reconstituted. Otherwise, it can lead to thermal shock i.e the death of some or all the essential live organisms in the vaccine.  Store the Diluents and droppers with the vaccines in the vaccine carriers during transportation .Diluents should not come in direct contact with the ice pack.
  • 23. MONITOR AND CONTROL OF TEMPERATURE:- Should be a Routine Activity. At the start and end of each working day Monitoring devices include:  Thermometers.  Temperature record sheets.  Refrigerator and freezer thermostat.  Cold chain monitoring card (CCM)  Vaccine vial monitoring(VVM)  Freeze watch indicator.
  • 24. CONT…  Thermometer: every piece of cold chain should be fitted with a thermometer.  Different types may be used, commonly mercury thermometer. i.e Dial thermometer ,Stem thermometer  Temperature record sheets: Record temperature of refrigerator or freezer.  Twice Daily: in the morning and afternoon. Any malfunction then should be reported.  Refrigerator or Freeze thermostat: Used to control storage Temperature.  Thermostat is set to suitable temperature.
  • 28. VACCINE VIAL MONITOR(VVM) A VVM is a label containing a heat – sensitive material which is Placed on a vaccine vial to register cumulative heat exposure over time .  Reading the stage of the VVM:-  Stage 2: The inner square is lighter then the outer Circle. if the expiry date has not been passed :use the vaccine  Stage 2: The inner square is still lighter than the outer Circle. if the expiry date has not been passed :use the vaccine
  • 29. CONT… Discard Point :  Stage 3: The color of the inner square matches that of the outer circle : Don’t use the vaccine Beyond the discard point  Stage 4: The color of the inner square is darker than the outer Circle. Don’t use the Vaccine.  The VVM does not directly measure vaccine potency but gives information about the main factor that affects potency i.e Heat exposure over a period of time.
  • 30. USABLE A N D UNUSABLE STAGES OF VVM