VACCINES, COLD CHAIN AND LOGISTICS MANAGEMENT

1 VACCINES, cold CHAINAND LOGISTICS MANAGEMENTM anual of OperationsVACCINES, cold CHAIN AND LOGISTICS MANAGEMENTD epartment of HealthNational Immunization Program5TH EDITION2018 MANILA, PHILIPPINESM anual of OperationsIntroduction3 Table of ContentsTable of ContentsList of FiguresList of TablesList of AnnexesForeword Acknowledgements Technical Terms and AcronymsIntroduction to the Manual35678910131518191921 Chapter 1. The Philippines cold CHAIN The cold CHAIN Health Facility cold CHAIN Vaccines in the National Immunization Roles and Functions of Staff Managing the cold CHAIN at Different Levels273034363639404243454750 Chapter 2.

2 Guiding Principles For vaccine and cold CHAIN Wastage Rate and Wastage Multi-Dose Vial Policy (MDVP) Buffer Monitoring vaccine and Safe Injection Bundling of Vaccines and Immunization The Shake First Expiry, First Out (FEFO) The vaccine Vial Monitor (VVM) Minimum and Maximum vaccine Stock Freezing and Conditioning Ice Proper Care of Vaccines during Defrosting of cold CHAIN EquipmentChapter 3. Calculating and Requesting Vaccines and Safe Injection Estimating Annual vaccine Estimating Annual Requirement for Injection Safety Determining Quantity of Vaccines and Safety Injection Equipment to be Placing Orders using the vaccine and Safe Injection Equipment Request Form5154565764 vaccine , cold CHAIN and LOGISTICS MANAGEMENT Manual of Operations46972 Chapter 4.

3 Receiving Vaccines and Safe Injection Pre-Arrival and Arrival of Vaccines7780818484899396100102105105107 Chapter 5. Storing Vaccines and Safe Injection Guidelines for Storing Safe Injection Equipment Heat and Freeze Sensitivity of Temperature Sensitivity of Immunization Temperature Monitoring Temperature Monitoring and Temperature Mapping Estimating Storage Determining the Existing cold CHAIN Calculation of Required vaccine Storage Estimating Storage Capacity of cold boxes and vaccine Types of Refrigeration Equipment for vaccine Guide for Proper Arrangement of Vaccines inside the cold CHAIN Equipment113116117118119121 Chapter 6.

4 Distribution and Transport of Vaccines and Safe Injection Supplies Distribution Recommended Actions before and during Transport of Passive Containers ( cold Box or vaccine carrier ) How to Arrange Vaccines in cold boxes and vaccine Maintaining the Correct Temperature of Vaccines in cold boxes and vaccine Carriers123126132133134 Chapter 7. Preventive Maintenance of cold CHAIN Preventive Maintenance Guide for cold and Freezer Recommended Actions if Storage Temperatures are Out of Defrosting vaccine General Care of cold CHAIN Equipment137140140141 Chapter 8.

5 Contingency Key Elements of a Contingency Actions to an Emergency at a Fixed Storage Possible EmergenciesList of References144 Introduction5 List of FiguresTitleThe cold CHAIN systemProportion of MMR vaccine wasted in Health Center ASamples of frozen vaccine vials of Tetanus toxoid (right ) and DPT (left )Interpreting the Shake Test resultVaccine vial with an expiration dateVVM label locationsVVM label at varying stagesHow to interpret the vaccine vial monitorSample of ice packsLayering Ice Packs inside the FreezerChecking Conditioned Ice PacksSample of vaccine Usage and Wastage Reporting FormSample of vaccine Usage and Wastage Consolidation DatabaseSample of Graphical Report Generated by the vaccine Usage and Wastage DatabaseSample of vaccine Request FormSample of Safe Injection Equipment Request FormSample of Temperature Monitoring Chart used per cold CHAIN

6 EquipmentSensor LocationSample of A Sketch of a Walk-in cold Room with MeasurementsCalculating the Existing vaccine Storage Capacity of a Front-Opening Refrigerator and FreezerMeasuring the Dimension of Top-Opening Refrigerator or FreezerDecision Tree in Selecting a Refrigerator or FreezerWalk-In cold Room and ShelvingVaccine Arrangement in a Front-Opening RefrigeratorLoading Vaccines in a Top-Opening Refrigerator with BasketLoading Vaccines in a Top-Opening Refrigerator without BasketsSamples of vaccine Transport Box and vaccine carrier and the Proper Arrangement of Ice PacksHow to Load a vaccine CarrierFive Steps in Preparing a cold Box for vaccine ShipmentUse of Foam Pad to Secure Opened vaccine Vial in a vaccine CarrierNumber 1234567891011121314151617181920 21222324252627 282930 vaccine .

7 cold CHAIN and LOGISTICS MANAGEMENT Manual of Operations6 List of TablesTitleList of NIP Vaccines and Recommended Doses and Storage TemperatureCauses of vaccine Wastage in Unopened and Opened VialsVaccine Wastage Rate and Corresponding vaccine Wastage FactorDOH-Recommended Buffer Stock Level and Usual Distribution CycleMain Indicators in Monitoring Vaccines and Immunization SuppliesExample of Calculating Bundled Vaccination LOGISTICS in an Area with a Total Population of 130,000 Types of VVM Attached to Different vaccine TypeVaccine Stock CardSpecifications of Injection Devices and Corresponding Wastage FactorGuide for Completing the vaccine Usage and Wastage Reporting FormGuide for Completing the vaccine and Safe Injection Equipment Request FormRecommended Timeliness of Submitting vaccine OrdersRecommended Actions during Vaccines Pre-Arrival and ArrivalChecking the Status of Ice Packs upon vaccine Arrival and Recommended ActionRecommended Storage Temperature of vaccine and DiluentsVaccines Sensitivity to Various

8 TemperaturesCauses of Heat Exposure and Recommended ActionsCauses of Freeze Exposure and Recommended ActionsTemperature Monitoring Options in Health FacilitiesTypes of vaccine RefrigeratorsAction Points for cold Rooms and vaccine RefrigeratorsAction Points for Freezer Rooms and FreezersSensor List for Temperature MappingSample Estimation of Total Required Storage Volume for VaccinesGuide for Using the Tool for Estimating Total Storage Volume Required for VaccinesGuide for Using the Tool for Estimating Total Storage Volume Required for Safe Injection EquipmentSample Estimation of Total Required Storage Volume for Safe Injection EquipmentSample Data on Storage Capacity of WHO Prequalified Refrigerators and Freezers per PQSS ample Form of Vaccines and Immunization Supplies Distribution PlanRecommended Actions if Storage Temperature are Out of RangeNumber 123456 789101112131415161718192021222324 a24 b25 2627 2829 Introduction7 List of AnnexesTitleTool for Bundling CalculationStock MANAGEMENT RecordStock Count for Syringes.

9 Safety boxes and Other ProductsVaccine Usage and Wastage Reporting - Form1 vaccine Usage and Wastage Database - Form2 vaccine Request Form (Revised, June 2017)Invoice Receipt of PropertyVaccine Arrival Report v. 2 vaccine Arrival Report for PPV23 and FluBill of LadingDifferent Types of Temperature Monitoring DevicesTemperature Monitoring ChartSensor Data Recording SheetSensor Replacement for Temperature MappingEstimating vaccine Storage RequirementWorksheets for Estimating Required vaccine Storage VolumeWorksheets for Estimating Required Refrigeration CapacityEstimating Safe Injection Equipment Storage RequirementCold CHAIN Inventory FormTool for Estimating Available cold Room Net Storage CapacityTool for Recording Available PQS cold CHAIN Storage VolumeVaccine

10 Allocation and Distribution PlanProperty Transfer ReportEmergency Situations Requiring Contingency PlanAnnex 123456789101112131415161718192021222324 vaccine , cold CHAIN and LOGISTICS MANAGEMENT Manual of Operations8 ForewordThe Department of Health presents this 5th edition of the cold CHAIN and LOGISTICS MANAGEMENT Manual of the Philippine National Immunization Program. It contains updates on standards and procedures, aimed at enhancing knowledge and skills of health workers in the delivery of quality basic immunization services, particularly in properly managing the vaccine cold CHAIN .