Table3:NationalImmunizationSchedule

ForPregnantWomen
TT-1 Earlyinpregnancy 0.5ml NO Intramuscular UpperArm

TT-2# 4weeksafterTT-1 0.5ml NO Intramuscular UpperArm

TT-Booster# IfreceivedTTdoses 0.5ml NO Intramuscular UpperArm

in a pregnancy
within the last 3yrs.

For Infants
BCG## At birth or as early Till one year 0.1ml Sodium Intra-dermal LeftUpper
as possible of age (0.05ml Chloride Arm
until 1
monthage)
Hepatitis B - At birth or as early Within24 0.5ml NO Intramuscular Antero-
Birthdose### as possible hours lateral side
ofmid-thigh
-LEFT
OPV-0*# Atbirthorasearly as Within the 2 drops NO Oral -
possible first15days

-
OPV1,2 &3 At6,10 &14 weeks Till5years of 2 drops NO Oral
age

RotaVirus At6,10 &14 weeks Till1year of 5drops NO Oral -

Vaccine* age

IPV At14weeks Upto1 yr. 0.5ml NO Intramuscular Antero-

(Inactivated ofage lateralside
PolioVaccine) ofmid-thigh
-RIGHT

Pentavalent’* At6,10 &14 weeks Tilloneyear 0.5ml NO Intramuscular Antero-

1, 2 & 3 of age) lateralside
ofmid-thigh
(Left)
Measles-1“ 9—12completed Given till 0.5ml Sterile Subcutaneous Rightupper
Dose months. 5yearsof Water Arm
age
Pneumococcal At 6 and 14 weeks Till one year 0.5 ml NO Intramuscular Antero-lateral
Conjugate and 9-12 completed of age* side of mid-
Vaccine 1,2 & 3 months thigh (Right)

DPT booster 1 16-24 months 7 years 0.5 ml NO Intramuscular Antero-lateral

& side of mid-
5-6 years thigh (Left) &
DPT Booster-2 Upper Arm
(Left)

TD 10 years & 16 years - 0.5 ml NO Intramuscular Upper Arm

 -
VitaminA At 9 completed Till 5years 1ml (1 NO Oral
(1"dose) months with of age lakhIU)
Measles

(2nd to 9th 16 months. Then, 2 ml (2 lakh

dose) one dose every 6
months. IU)

8 HandbookforVaccine&ColdChainHandlers,India2016
 BeWise!
etyourchild
fullyimmunized

Remember

• Check circuit,identifythefaultand • positionandfunctioningof

get it corrected MCBofstabilizerandconnectivity
• Informelectricitydepartmentfor with equipment
earlyrectification • bilizerplugissecuredto
• Inform Block Medical Officer/District power socket
Immunization Officer • Oncompressorfailure,temperature
• Inquire from the electricity fluctuations or any other
department within what time non-functionality;informColdChain
electricity supplywillberestored Technician

Vaccinestorageincoldbox
-3• Arrangeconditionedicepacksatbottomandalongthewallsofcoldbox(asrecommendedbymanufacturer)
••3 Keepvaccinevialsinboxesorpolythenebagsandarrangethemensuringproperaircirculation
••3 Keepathermometerbetweenvaccineboxes.Donotopenthecoldboxunlessrequired
••3 Afterarrangingvaccineboxeskeeptwolayersofconditionedicepacksontopandpackthecoldbox
-3• EnsurethatDPT,TT,PentavalentandHepatitisBvaccinesarenotplacedindirectcontactwithicepacks

If cold box is unavailable or power Periodically monitor storage

failure is for more than 72hours- temperatureofequipmentwith
transferallvaccinestonearesthealth thermometer
facility with cold chain or to district Ifstorage temperature ismorethat
cold chain. 8°C,transfervaccinesintocoldbox

Importantcontactnumbers
ColdChainHandler...................................................................................................................................
MO incharge.........................................................................................................................................
DistrictImmunizationOfficer...................................................................................................................
DistrictColdChainTechnician.................................................................................................................
ElectricityDepartment...............................................................................................................................
Firedepartment.........................................................................................................................................
NearestColdChainPoint(CCP)................................................................................................................
FacilityinchargeofnearestCCP..............................................................................................................
ColdChainHandlerofnearestCCP.........................................................................................................

92•HandbookforVaccine&ColdChainHandlers,India2016
Figure12:StorageofvaccineinILR

28•HandbookforVaccine&ColdChainHandlers,India2016
 BeWise!

I.c.n.
+2°Cto
+8°C

-15°Cto
-25°C

Monitortemperaturetwicedailyandrecorditin
temperature log book.
Ensurethatthetemperature ofILR/WICismaintained
between +2°to +8’C and DF/WIF between -15’C
to-25“C
Cold Chain Technician should annually
validatethefunctionality ofThermometer.
Non-functional thermometers
shouldbediscardedasper
procedure.

50•HandbookforVaccine&ColdChainHandlers,India2016
 BeWise!
etyourchild
immunized

GeneralPrinciples
• Correctvoltagesupplyiscriticalforoptimalfunctionality and
troublefreelifeofequipment.
• Goodqualitywiring,sockets,plugsandstabilizers ensures
regulated voltage to ILR/DFs. Stabilizer must
befunctionalandoutputvoltageshouldbecloseto220-230volts.
• Validatethermometeronceevery12monthsorwithevery
changeofthermometer/DigitalTempController. "
• MaintainTemperatureLogbookforeachColdChainEquipment
usingfunctionalthermometerordigitaldevicesprovidedunderthenational
programme.
• Keep10cmsdistancebetweenILRandwallsorbetweentwo
equipments.
• Outersurface of ILR/ DFs should be clean.This willallow faster heat dissipation
from condenser coil.
• TheILR/DFsshouldbeplacedonplasticorwoodenstands.
• Hygiene iskey toavoid AEFI by ensuring clean septum cap.Ensure
cleanlinessof vaccineand lcepack chambe aswellas
Coldbox, vaccine carriers andice-packs.
• Only UIP vaccines &diluentsshould bekept insideILR,andIcepacksinthe deep
freezers.
• ForILR:Thermostatshouldbeconfiguredto+5C,sothattherangeof
+4°Cto+6°Cismaintained.
• ForDF:Thermostatshouldbeconfiguredto-19C,sothattherangeof-18°Cto
-2O°Cismaintained.
• Rubbergasketofthelidneedstobecheckedforgaps.
• Latch&hingesshouldbecheckedforproperfunctioning,toensurenoga
• Checklocationofthermometer.Itshouldbepositionedalongwiththe
vaccines.
• Checkifdigitaldisplayisfunctional.
• Checktheorderofvaccinesto Ensurethattheyarestackedin
thebasket,suchthatairmovementispossible.
• Check ifIce-packs arefrozen correctlyandtheyarenotdeformed.
Ensurethatice-packs arestackedtoallowairmovement.
• Checkifcondenserfanbladesareclean,tosaveelectricity.
• Checkvaccines forlegiblelabel/expiry&VVMstatus.
• DefrostifthereisanyiceinsidetheILRortheice-liningismorethan5mminDF.
• Cleanthe drainplug.

58 HandbookforVaccine&ColdChainHandlers,India2016
 AL

Pe‹kege
Cerefutty!!
Put frozen Ice-packs Placethisconditioned
" Ice-packsinavaccine
on top of a table. carrier/cold box.
Waittilltheiceinside
theice-packstarts a' PloceoDipper
melting. bogcontainingollrequiredV
CheckIce-packsbg occines
shakingittillyousee fidiluentsinthecentre.
/listento woter. Wipe Donotopenthelidofv
the ice-pack and occinesorrierunless
make the outer obsolutelpnecessorq
surface dry before AlwagskeepVaccine
placingitinvaccine Carrierinshade.
carrier/cold box.
Ice- CheckIce-
packsona packsbgshaking
it for melting
table
1ce

Be Wise!
et your child
fullyimmunized
 BeWise'

PRZSZRVZLIFZ
Open VialPolicy applies only for DPT,TT,
Hepatitis B, Oral Polio Vaccine (OPV) &
Liquid Pentavalent.

}t' Does notapply toMeasles,

BCG, Japanese
Encephalitis (JE) vaccines.

Vaccine vials opened in session-site conbeused in more than one

immunization session up to four weeks provided:
eExpirydotehasnotpassed.
eVaccines ore stored strictly under appropriate temperature
rangebothduringtransportation&storageatcoldchainpoint.
eVaccine vialseptum has not submerged in water or
contaminated in any way.
eAseptictechniquehasbeenusedtowithdrawalldoses.
eVaccine vialmonitor (VVM), has not reached discord
point.
Open vials should never be submerged in water
(e.g.Water accumulated in vaccine carrier) as it
increases the risk of contaminationofthe vialsep
Ensure all open vials hove recorded dote and time of
opening.
At the end of the session, alt open vials should be returned to
Cold Chain Point.
At ColdChainPoint,open vialsshould besegregatedinto: eRe-
usable DPT, TT, Hep B and Pentavalent vaccine vials
fulfllingtheabove mentionedcriteria.
eNon-reusableopenvialsofMeasles,BCG&JE
All open vials of BCG, Measles and JE should be destroyed after
48 hours or before next session, whicheveris earlier.
In case of any AEFI reported, all open vials (usable &non-usable)
should not be discarded or used. All open vials should be stored
under proper cold chain till investigationis complete.
All vials (open or unopened)should be transportedin a zipper bog in
the vaccine carrier and recorded in the stock register.
Well-sealed conditioned ice packs should be used in vaccine
carriers and water should not be allowed to accumulate where
vaccine vials and diluents ore stored.

74 HandbookforVaccine&ColdChainHandlers,India2016
1. PrepareIce-PacksforFreezing 2. ConditionFrozenIce-Packs
• FiIItheIce-PacI‹swithwatertomark.
checkwaterlevelbeforeeveryuse.
« PlacefrozenIce-PacI‹sintheopen
tillthey"sweat,"(somecondensatlon • G
Do NOTaddsalt tothiswater. or droplets of water).
• Fitthestoperandscrewonthe « Checl‹IfanIce-Packhasbeen
cap tightly. conditionedbyshamingItand
• MakesuretheIce-Packdoes listeningforwater.
notleak.
Unconditioned ice-pec/ts may damaga
« WipetheIce-Packdryandplace freeze sensitiveVacffines (DPT, TT,IPV,
Inthe Deep Freezer. Penta and Hepatitis B).
 InColdBox with
Conditionedice
kS
StorageEquipment WIC ILR(L) ILR( ) paC
Storage +2°to+8° +2°to+8° +2°to+8° +2°to+8°
Temperature
Maximumstock 2.75 2.75 2.75
(months)
Minimumstock 0.75 0.75 0.75 05
(months)

StorageEquipment WIF WIF DF(L) ILR(S) Incoldboxwith hard

frozen icepacks
Storage -15°to-25° -15°to-25° -15°to-25° +2°to+8°
Temperature
Maximumstock 2.75 2.75 2.75 1.5
(months)
Minimumstock 0.75 0.75 0.75 0.5
storage(months)
Storage Transportation

4 RefrigeratedvaccineVan
4 Walk-in-Cooler(WIC)
4 Insulatedvaccinevan
4 Walk-in-Freezer(WIF)
4 ColdBox
4 Ice-linedRefrigerator(ILR)
4 Vaccinecarrier
4 Deepfreezer(DF)
4 Domestic Refrigerator

4 SolarRefrigeratorBattery
Dfive
4 SolarRefrigeratorDirectDrive

4 ColdBox,
4 VaccineCarrier
 Neverstore
SmaIIcompartmen
arrangeandstore
In the DF, Use
frozen lcepacks
only for freezing
verticallyinlayersalso
kepacks
storeincoldboxes

icepacksfor
freezlng

Storefrozen

ofthearge
rtment

thermometer
Large compartmentWipe insideand
dry and arrange 20-25
unfrozenicepacks vertically temperature
(never nat) ina crisscross beMeen-16°to
patternwithspaceforair
-25°C (monitor
circulation
everymorningand
even ng)
 Numbers Numbersin
inREDare BLUE are
for below for above
zero (-) zero (+)
temperature temperature

ILR:+2°Cto
+8°C

DF:-15°Cto
-25°C

Donotholdhere

AlcoholStemThermometer
Mostsensitive

BCG(afterreconstitution) Mostsensitive
OPV, Rota virus vaccine
IPV
Measles(bothbeforeand 4 Hep.B
afterreconstitution) 4 Pentavalent
+ JE(bothbeforeandafter IPV
DPT
reconstitution)
DPT
BCG(before
reconstitution)
+V Leastsensitive
4 Pentavalent,Hep.B
Leastsensitive