Central Store for a Mass Vaccination Campaign
Basic unit:
N/A
Estimated Price:
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Specification
Introduction
This kit is designed to serve as central store to feed several Distribution sites. As such, is mainly a transit store and it is not meant to hold the entire stock of cold chain and dry store commodities.
Most countries now have well-established immunization services and a network of
vaccine stores. When possible, it is better to use the existent capacity if it s proven to be reliable.
This solution is focusing in the cold chain set up and its implementation, and it does not suggest storage for dry items, since this depends of the context and structures available where the Central store is located.
Keep in mind that the capacity of refrigerators ranges approximately between 30L and 200L of net vaccine storage volume. For storage facilities with required capacity exceeding a considerable number of refrigerators, a cold room could be less flexible but a more efficient solution. Walk-in cold rooms (WIC) and walk-in freezer rooms (WIF) are refrigerated enclosures accessible via at least one door and large enough for a person to walk into, housed within existing buildings. Consider that WICs and WIFs are compression type refrigerators and require reliable power supply.
Choosing a location
The geographical distribution of population and health facilities determines where vaccines are needed. The location of vaccine supply, mainly airports and the location of the Distribution sites determines where the primary storage points should be located.
Storage planning starts with an analysis of the supply requirements in order to establish the quantity of vaccines needed by each facility and the overall volume to be handled by the distribution system.
Mapping the locations of the distribution sites and vaccination sites will determine the availability of transport among the different stores and the volume of the cold chain.
It is essential to have good transport routes linking primary and intermediate stores.
Vaccine stores should be housed in permanent buildings, which should be designed and constructed to a good standard that is appropriate for local climatic conditions. Temporary buildings should be avoided.
The best option is to have the cold chain, medical stock, logistics stock, vehicles and fuel all in the same place. All of the teams are supplied from this central point.
If it is impossible to find a large enough space, make sure to find spaces that are near each to other to facilitate organisation and supervision.
If possible, choose a large city and a location that is accessible at all times, with round-the-clock electricity to ensure continuous cold production (refrigeration and freezing).
Lay Out of the Central Store Site
The central storehouse is laid out in five sectors of varying floor space:
– Active cold chain (freezers, refrigerators and cold room): 0.3 m3/1,000 doses
– Passive cold chain: 2.85 m2/vaccination team
– Renewable medical equipment and supplies: floor space depends on estimated needs
– Logistics equipment and supplies: floor space is a function of estimated needs
– Vaccination module preparation area (2.5 m2/team)
Management
Human resources
Stock management is entrusted to a trained manager, aided by one or more assistants. Each person’s tasks are clearly defined. One of the assistants should be able to fill in for the manager in case of absence.
In order to manage the Cold chain, there should be:
A technician (aided, if necessary, by an assistant) is responsible for:
– installing refrigerators and freezers and turning them on at least 24 to 48 hours before vaccines arrive;
– appliance operation, maintenance and repair;
– monitoring temperatures;
– preparing the cold boxes and vaccine carriers for transport to the sites (cleaning and loading the ice packs and placing the thermometer in the cold boxes);
– freezing the ice packs.
A pharmacist (or member of the medical staff) is responsible for:
– managing the stock of vaccines and diluents;
– preparing the vaccines and diluents that are sent to the vaccination sites daily;
– checking the unused vaccines and diluents at the sites, which are put back into stock.
Tools
The main stock management tool to be used is the Stock Card (refer to the solution “Stock Card”)
Determining the size of the vaccine storage
The vaccine storage depends of the type of vaccine and its temperature requirements. Vaccines can be classified as:
Currently, all vaccines can be stored at “keep cold” and Keep frozen; most of the commercial solution provide this temperature and are available in most contexts. Only the COVID19 Pfizer needs to be stored at Keep deep frozen. For this one, it is recommended to use the equipment provided by the manufacturer:
Pfizer recommendations on storage:
• Unless a provider opts out, dry ice will be delivered within 24 hours of vaccine delivery to refill the thermal shipping container for the first re-ice only. Additional dry ice will not be provided. Locate a dry ice source if planning to use the shipping container to store vaccine for more than 5 days.
• Do not use or store dry ice or liquid nitrogen (LN2) in confined areas, walk-in refrigerators, environmental chambers or rooms without ventilation. A leak in such an area could cause an oxygen-deficient atmosphere.
• A full shipping container with vaccine and dry ice weighs approximately 80 pounds
Source: Product Information Guide.pdf
Target population, transport availability and vaccination plan determines the maximum volume storage needed.
The estimated volume per dose (or packed vaccine volume) quantifies the space needed to store or transport vaccines and diluent and will depend on the number of doses per vial, the physical size of the vial or ampoule (primary package) and the bulkiness of the external packaging (secondary packages).
Attachment 1: Walk in Cold and Freeze rooms storage capacity as WHO recommendations
Attachment 2: How to calculate the net storage capacity of a cold room
NB: The utilization factor is a correction considering that it is not possible to use the nominal storage volume due to a different factors like lay out, size of packaging, etc. It is a WHO recommendation
Important Notice: The Central Store should be equipped as well with the capacity to produce ice packs for transporting the vaccines to the Distribution Sites. See the DS about calculating the production of ice packs.
Link to the following solutions:
Sources: