title: Relationship between vaccine vial monitors and cold chain infrastructure in a rural district of India.
abstract: BACKGROUND
  The potency of oral polio vaccine (OPV), a heat-labile vaccine, is preserved by the cold chain. The Vaccine Vial Monitor, a heat-sensitive label, is critical to the monitoring and maintenance of the cold chain. This study was conducted to evaluate the relationship between the adequacy of cold chain infrastructure and the proper use of Vaccine Vial Monitor in a rural district of India.
  
  
  METHODS
  Forty-six health centers in a rural district were included in our evaluation of the cold chain equipment and the Vaccine Vial Monitors. Cold chain equipment and vaccine vials within each health center were evaluated for adherence to WHO cold chain maintenance protocols and the Vaccine Vial Monitor stage, respectively.
  
  
  RESULTS
  Among the 46 health centers, Vaccine Vial Monitor stage I was found at 58% of the health centers, 33% of the health centers reported stage II and 9% reported a stage III, indicating weaknesses in the cold chain mechanism
  
  
  CONCLUSIONS
  Cold chain for the OPV was not adequately maintained at primary and sub-health centers in this rural district. Well maintained ice packs and vaccine carriers will help ensure delivery and availability of a safe and potent vaccine to children in rural areas of India.
authors.affiliation: Park Nicollet Institute, Minneapolis, MN, USA. sama0038@umn.edu
authors.forename: Y
authors.initials: Y
authors.lastname: Samant
authors.forename: H
authors.initials: H
authors.lastname: Lanjewar
authors.forename: L
authors.initials: L
authors.lastname: Parker
authors.forename: D
authors.initials: D
authors.lastname: Block
authors.forename: B
authors.initials: B
authors.lastname: Stein
authors.forename: G
authors.initials: G
authors.lastname: Tomar
mesh_terms: D016903:Drug Monitoring; D004356:Drug Storage / Q000379:methods; D006801:Humans; D007194:India; D011055:Poliovirus Vaccine, Oral / Q000737:chemistry*; D012034:Refrigeration / Q000379:methods*; D019035:Rural Health Services / Q000458:organization & administration*; D013997:Time Factors
chemical_list: D011055:Poliovirus Vaccine, Oral