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Indian Journal of Community Medicine

Awareness of Oral Polio Vaccine Vial Monitor Among the Polio Booth Staff

Author(s): A. Puri, M. Mehra

Vol. 29, No. 4 (2004-10 - 2004-12)

Introduction

In tropical country like India maintenance of cold chain is of paramount importance. Considering the thermoliability of OPV, OPV vials were supplied with vaccine vial monitor (VVM) affixed on them. The VVM is a small square, made of heat sensitive material placed on an outer coloured circle printed on the label of the OPV vial. Combined effect of time and tempeature causes VVM to change its colour from light blue to violet, to a shade darker to deep purple with breakdown of cold chain. This helps the field worker to identify cold chain disruption and heat exposure of the vaccine vial over a period of time. The present study was done to assess the awareness of polio staff about the vaccine vial monitor.

Materials and methods

The study was conducted during National Immunization days in National Capital in year 1999-2000. There were five rounds of intensive pulse polio immunization conducted from October 1999 to March 2000. The study was primarily conducted in a Central Reserve Polio Booth and 20 adjacent polio kendras in West Zone Delhi. The data was collected by interviewing the staff members posted for IPPI by using a predesigned and pretested questionnaire. Interview schedule contained questions about VVM, its function, how to read and interpret. Analysis was done on computer.

A total of 220 persons were interviewed out of which 52 (23.6%) were doctors/medical students, 44 (20%) were nursing staff, 43 (19.5%) were Group C staff and 42 (19.1%) and 39 (17.7%) were Group D and volunteers respectively. There was significant difference in the awareness level regarding VVM amongst the staff categories (p< 0.001). Out 220, only 95 (43.5%) staff members had ever heard of VVM. If volunteers were excluded overall awareness level of staff members posted at polio booths was found to be higher (52.5%). Highest awareness level was found in Grp A staff (75%) followed by Grp B staff (65.97), gpc (25.6%), volunteers (20.5%) and group D (29%) respectively.

These 95 staff members were further interviewed, 87 (91.6%) were aware that VVM was present on vaccine vial itself of which 75 (78.9%) could correctly identify as inner square with outer circle. 8 other members who were aware of VVM thought if to be an indicator on the vaccine carrier. Only 66 (68.4%) were aware of its function and only 58 (54.7%) knew when to discard the vaccine i.e., when VVM square matches or is dark than the outer circle. as given in table I.

Even though 58 staff members knew when to discard the polio vaccine vial, none of them said that they would inform the booth supervisor.

Discussion

The first OPV immunization days using intensive social mobilisation were organised in Delhi in 1994, when over 90% of children in most areas of the state were immunized2. The first NID was organized in 1995, targetting children aged under 3 years throughout India. The 4 NIDs organised since 1996 targetted children under 5 years and achieved national coverage exceeding 90%3. On average atleast 125 million children have been immunized every year in NIDs since 1996 and 133 million in 1999.

Table I : Awareness pattern among various staff categories about VVM

Saff Group N Site/Location of VVVM Description of VVVM Fn/How is VVVM Read When to Discard Vaccine
  On Viral Elsewhere Correct Incorrect Correct Incorrect Correct Incorrect
A 39 38 1 36 3 36 3 36 3
  (97.4%) (2.6%) (92.3%) (7.7%) (92.3%) (92.3%) (7.7%) (7.7%)
B 29 27 2 24 5 23 6 22 7
  (93.1%) (6.9%) (82.8%) (17.2%) (79%) (20.6%) (75.9%) (24.1%)
C 11 9 2 9 2 4 7 0 11
  (81.8%) (18.2%) (81.8%) (18%) (36.4%) (63.6%) (0%) (100%)
D 8 7 1 4 4 2 6 0 8
  (87.5%) (12.5%) (50%) (50%) (25%) (75%) (0%) (100%)
V 8 6 2 2 6 0 8 0 8
  (75%) (25%) (25%) (75%) 0% (100%) (0%) (100%)
Totals 95 87 8 75 20 65 30 58 37
  (91.6%) (8.4%) (78.9%) (21.1%) (68.4%) (31.6%) (61.1%) (38.9%)

More than (56.8%) half of the staff members intrviewed had not heard of VVM. For those, who had heard, their awareness regarding its function, how to read and when to discard it was poor. Thus, there is a need for effective training of staff in subsequent PPI rounds so that an effective cold chain may be maintained.

References

  1. Global eradication of poliomyelitis by this year 2000, Geneva, WHO, 1988 (World Health assembly resolution WHA 41-287)
  2. Bandyopadhyay S et al. Evaluation of Mass PPI & Oral Polio Vaccine in Delhi : is pre-registration of children necessary? Indian Journal of Paeds, 1996, 63:133-137.
  3. Banerjee K, Andrus J.K. Hlady G. Conquering Polio in India. Lancet, 1997, 349:1630.
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