Vaccine storage in pharmacies on the Central Coast of New South Wales

Reimer, Robert F.; Lewis, Peter

doi:10.1111/j.1467-842x.1998.tb01189.x

Cited by 7 publications

(5 citation statements)

References 5 publications

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“…2 The data loggers had a temperature range from -5 to 37°C. They were placed as close as possible to the middle of the fridge and set to take 1800 readings over a six-day period, representing a reading every 4.8 minutes.…”

Section: Methodsmentioning

confidence: 99%

“…There is increasing evidence that vaccine potency is compromised during storage in the community setting, mostly resulting from freezing vaccines. [1][2][3] Our knowledge of vaccine immunogenicity when storage temperatures depart from the recommended range is incomplete. Exposing vaccines to higher temperatures (22 to 25°C) generally shortens their shelf life with mostly marginal effects on immunogenicity.…”

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confidence: 99%

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Evaluating the efficacy of vaccine storage in the general practice setting

Lewis

Reimer

Dixon

2001

Australian and New Zealand Journal of Public Health

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Objectives: To describe the implementation of guidelines for vaccine storage in general practice, and their effectiveness in achieving optimum vaccine storage temperatures in fridges. Design: Repeated cross‐sectional surveys over time ‐ phase 1 1996/97, phase 2 1998/99, phase 3 1999/2000. Setting: Central Coast, New South Wales. Participants: Phase 1 — all general practices on the Central Coast. Phases 2 and 3 — samples of practices. Interventions: Each practice was surveyed about how they stored vaccines. A datalogger recorded fridge temperatures over six days. Individual feedback and advice were given. Main outcome measures: Proportion of: 1. fridges maintaining a temperature in the 2–8°C range; 2. fridges freezing; 3. practices with one person responsible for vaccine storage; 4. fridge temperature checked daily; 5. fridges storing no items other than vaccines; 6. fridges with thermometers; and 7. associations between storage practices and fridge temperatures. Results: In phase 1, 102 fridges, and in phase 3, a random sample of 36 practices was surveyed. The findings for phase 1 and phase 3 respectively were: 31% and 50% of fridges were in the 2–8°C range; 36% and 25% were <0°C; one person was responsible in 52% and 53% of cases; 20% and 38% reported daily checks; 74% and 94% of fridges had no extraneous items and 53% and 86% of fridges had thermometers. No statistically significant associations were found between vaccine storage practices and fridge temperatures. Conclusions: Despite improvements in vaccine storage practices, a quarter of fridges were freezing, thereby compromising the potency of many of the immunisation schedule vaccines.

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Section: Methodsmentioning

confidence: 99%

mentioning

confidence: 99%

Evaluating the efficacy of vaccine storage in the general practice setting

Lewis

Reimer

Dixon

2001

Australian and New Zealand Journal of Public Health

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“…Several cold chain monitoring studies have reported that vaccines were inadvertently exposed to freezing temperatures at alarming frequencies. [2][3][4][5][6][7][8][9][10][11] In some cases, one vaccine shipment was exposed to several episodes of freezing temperatures during cold chain storage and transport. 2,[4][5][6][7] Accidental freeze exposure of vaccines is not limited to resource-constrained settings; a review showed that similar problems are frequently found in developed countries where temperatures are supposedly closely monitored.…”

Section: © 2 0 0 8 L a N D E S B I O S C I E N C E D O N O T D I S mentioning

confidence: 99%

Characterization of the freeze sensitivity of a hepatitis B vaccine

Chen¹,

Tyagi²,

Carpenter³

et al. 2009

Human Vaccines

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Recent studies have revealed that vaccines containing aluminum adjuvant are exposed to sub-zero temperatures while in the cold chain more frequently than was previously believed. This raises concerns that these freeze-sensitive vaccines may be damaged and offer inadequate protection. This study was undertaken to characterize the immediate qualitative changes of one such vaccine, hepatitis B, caused by freeze exposure. Hepatitis B vaccine was subjected to freezing temperatures ranging from 0 degrees C to -20 degrees C for up to three episodes with durations ranging from 1 hour to 7 days. The vaccine was analyzed for freezing point, particle size distribution, tertiary structure, and in vitro and in vivo potency. Whether or not hepatitis B vaccine freezes was shown to be dependent on an array of factors including temperature, rate of temperature change, duration of exposure, supercooling effects and vibration. Vaccine exposed to "mild" freezing (-4 degrees C or warmer) temperatures did not freeze and remained qualitatively unaltered. Single or repeated freezing events at temperatures of -10 degrees C or lower were associated with aggregation of the adjuvant-antigen particles, structural damage of the antigen, and reduction of immunogenicity in mice. Damage to the vaccine increased with duration of freezing, lower temperature, and the number of freezing episodes. With vibration, vaccine froze at -6 degrees C after 1 hour and damage occurred. Freezing and freeze damage to vaccines containing aluminum salt adjuvant represent real risks to the effectiveness of immunization and should be prevented by strengthening the cold chain system or, alternatively, development of freeze-stable vaccine formulations.

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“…For example, a number of studies have found that many refrigerators used to store vaccines had temperatures outside the recommended range of 2°C to 8°C (e.g. Reimer and Lewis 17 ). There are many situations in which such facilities do not exist, or storage requirements prevent their use, and medications will be exposed to ambient (or close to ambient) climatic conditions.…”

Section: Discussionmentioning

confidence: 99%

Impacts of climate and climate change on medications and human health

Beggs

2000

Australian and New Zealand Journal of Public Health

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Objective:To examine impacts of climate and climate change on medications and human health. Methods:Literature review and analysis of MIMS. Results:Changed climate associated with the enhanced Greenhouse Effect (e.g. increased temperature) may lead to medication‐related health impacts through deterioration of storage conditions, increased heat stress from medication‐induced heat intolerance, and by influencing pharmacokinetics. Increases in UV radiation from stratospheric ozone depletion may increase the significance of medications that can lead to an increased sensitivity to the damaging effects of UV radiation (i.e. photosensitivity). Conclusions and Implications:Raising awareness of the impacts of climate on medications, and of climate‐related side‐effects, among both health care professionals and the public, should modify behaviour and therefore reduce the risks of such adverse impacts.

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Vaccine storage in pharmacies on the Central Coast of New South Wales

Abstract: Pharmacies on the Central Coast of NSW were surveyed to assess the ability of refrigerators used for vaccine storage to maintain the recommended temperature range (2 to 8OC). Refrigerators used for vaccine storage were monitored over a 3-day period using a temperature data logger.

Cited by 7 publications

References 5 publications

Evaluating the efficacy of vaccine storage in the general practice setting

Evaluating the efficacy of vaccine storage in the general practice setting

Characterization of the freeze sensitivity of a hepatitis B vaccine

Impacts of climate and climate change on medications and human health

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