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Letters to the Editor

Indian Pediatrics 2001; 38: 107-108

Vaccine Vial Monitors

We read with interest the letter from Dr. Yelsangikar on use of the Vaccine Vial Monitor (VVMs), and the response by Prof. Jacob John(1,2).

There are some important points worth making. First, as Dr. Yelsangikar suggests, WHO and its partners have seen the advantages of the VVMs, and they will be supplied on all vials of vaccine procured through UNICEF Supply Division as of 1 January 2001. The advantages of the VVMs include not only increased ability to judge whether a particular vial of vaccine has lost potency due to heat exposure, but also the facilitation of vaccine management and outreach activities. The WHO-UNICEF policy statement on the use of vaccine vial monitors in immunization services (WHO/V&B/99. 19 available from WHO Department of Vaccines and Biologicals in Geneva, or through our website) outlines and documents these advantages.

Furthermore, as Dr. Yelsangikar suggests and as Dr. Jacob John reiterates, WHO has adopted a policy on use of multi-dose vial of liquid vaccines beyond the end of an immunization session. Lyophilized vaccines, such as BCG, measles and yellow fever, once reconstituted, should be discarded at the end of six hours to avoid both loss of potency and potential harm to recipients because of lack of preservatives in these formulations. WHO’s policy statement on the use of opened mutlidose vials of vaccine in subsequent immunization sessions (WHO/V&B/00.09) provides guidance on how to implement this policy.

These policies have been also outlined and explained in Mr. Zaffran’s article(3) refer-enced by Dr. Yelsangikar. We welcome this opportunity to bring these new policies and practices to the attention of readers of Indian Pediatrics.

Julie Milstien,
Acting Coordinator,
Access to Technologies,
Vaccines and Biologicals,
World Health Organization,
CH-1211 Geneva 27-Switzerland

  1. Yelsangikar R. Vaccine Potency: A doctor’s dilemma. Indian Pediatr 2000; 37: 1023.

  2. John TJ. Reply. Vaccine Potency: A doctor’s dilemma. Indian Pediatr 2000; 37: 1023-1024.


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