Cold Chain
Surveillance Coordinator
Provincial EPI cell
What is cold chain system
• From the manufacture to the recipient, all
the steps n people involved in keeping the
vaccine in the required temperature is
called the cold chain system
The cold chain
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Vaccines are sensitive biological.
Needs special attention.
Damages by heat – freezing.
Once potency is lost – cannot be regained.
Requires special storage mechanism.
From manufacturer to site of use.
Two major factors.
» Staff
» Equipment
Current vaccine
management system
EPI cold rooms
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Peshawar.
Malakand.
Mansehra.
Kohat.
Bannu.
D.I.Khan.
Location of cold rooms
Vaccine storage
• Ideal temperature (2 to 8 ) so that
pneumococcal, penta & TT do not freeze
• Polio if needed to be stored for more then
3 months can be stored in – 20.
• Thermometers
– Dial, cold chain monitor card, mercury
• VVM, Shake test
Conclusion.
• Good installations are available.
• Have trained staff posted.
• Have the vaccine storage capacity for entire
divisions.
• Working back up is available in most of the cold
rooms.
• Stock registered are maintained.
Conclusion-2
• Cold rooms remained out of order for considerable
time.
• No mechanism for local repair.
• No allocation for POL of generators.
• Did not serve during the past 2 years.
• No proper supervision mechanism of concerned
staff.
• No leave account maintained.
• No written job description of staff.
• Not trained on storekeeping.
Conclusion-3
• No procedures for
• Receiving vaccines.
• Issuing vaccines. (vit A during NIDs)
• No proper vaccine management system. (Frequency &
quantity of vaccine)
• Vaccine is collected from provincial cold room
instead of divisional.
• Divisional cold rooms are under utilized.
• No allocation for maintenance and repair.
Suggestions
• Much more is desired to be done.
• Vaccine management system.
• Date of collection – vaccine stock at different levels.
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Regular review/signing of stock registers.
Mechanism for monitoring of the system.
Development of SOPs for various tasks.
Using checklists for various occasions.
Suggestions-2
• Ensuring vaccine stock at every level.
• Collection of vaccine from divisional, instead of
provincial cold room.
• Allocation of maintenance and repair funds beyond
the PC-1 period.
• POL issue for generators to be taken.
Suggestions-3
• Training of personnel on storekeeping practices.
• Installation of automatic temperature recording
equipment.
• Developing mechanism for utilization of technical
staff.
• Provincial cell should deliver vaccine to cold rooms.
Proposed vaccine management system
• Vaccine should be collected from federal cell on
quarterly basis.
• Provincial store to supply vaccine to cold rooms.
• Divisional cold room have 3 months quota.
• Districts will collect vaccine from divisional cold
rooms.
• District stores – 2 months supply.
• EPI centers – 1 month stock.
Checklist for receiving vaccine
• When Vaccine Consignments Arrive at the Storage
Point :
• All details of the consignment must be
checked.
• All detail be recorded in the stock register.
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District
Name of cold room/store/health facility
Name of storekeeper/worker
Designation
– The type of vaccine
• The quantity received (in doses)
• The vaccine manufacturer
• The batch or lot number.
• The expiry date.
• The status of the VVM
• Balance
Issuing vaccine
• Record of each consignment leaving the store is
appropriate.
• All details should be recorded.
– The quantity issued.
– Batch number.
– Expiry dates .
– To whom issued.
– The remaining balance.
While vaccine is in storage
• All vaccines must be systematically arranged .
• Older stock should normally be distributed first.
(FIFO).
• Expiry must be checked regularly.
• All stocks must be distributed well before their
expiry date.
• Ensure that no batch or lot remains too long in
storage.
• Regularly check the integrity of the stocks by
reviewing the status of VVM.
• Any expired, damaged or vials with VVMs beyond
the discard point should not appear in the stock
balance.
• Vaccine demand
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Requirement/Target.
Vaccine in balance.
Consumption in previous month (s)
Vaccine received in previous month.
Vaccine issued.
Vaccination coverage.
Thank you