Exposure of hepatitis B vaccine to freezing temperatures during transport to rural health centers in Mongolia
Exposure of hepatitis B vaccine to freezing temperatures during transport to rural health centers in Mongolia
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DOI：
10.1016/j.ypmed.2004.01.029
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发表时间：
2004-08-01
影响因子：
5.1
通讯作者：
Densmaa, B
中科院分区：
文献类型：
--
作者：
Edstam, JS;Dulmaa, N;Densmaa, B
背景先前对蒙古B型肝炎病毒（HBV）婴儿疫苗接种计划的评估显示，只有70%的农村受试者产生保护性抗体水平，而城市受试者为94%。这种差异可能是由于农村婴儿接种的疫苗受损。HBV疫苗是热稳定的，但冷冻破坏免疫原性。目前的研究旨在确定HBV在运送到农村卫生中心的过程中是否会受到冷冻温度的影响。在2001 ~ 2003年的几个时间段内，使用3 M Freeze Watch（TM）指示器监测从国家疫苗商店运输到省级商店和从两个省级商店运输到农村卫生中心的HBV疫苗的冷冻情况。在181次省到农村的运输中，19%（95% CI 13-25%）导致冻结。其中59或1.6%（95% CI 0-5.6%）的国家到省的商店运输表明冻结。在每个子研究的后半部分，冻结事件减少。运输的持续时间与冷冻有关。在从省到农村的疫苗运输过程中，对冰冻温度的识别提供了HBV疫苗被损坏的证据。这可能是蒙古农村疫苗反应不佳的原因。作者推测，用冰包装疫苗运输直接从储存在-20 ℃的深冻中取出是冷冻的原因。(C)2004年癌症预防研究所和爱思唯尔公司。All rights reserved.
Background. A previous evaluation of the Mongolian hepatitis B virus (HBV) infant vaccination program showed that only 70% of rural subjects developed protective antibody levels compared to 94% of urban subjects. The difference is likely due to damaged vaccine being administered to rural infants. HBV vaccine is heat-stable, but freezing destroys immunogenicity. The current study was designed to ascertain if HBV is subject to freezing temperatures during transport to rural health centers.Methods. During several time periods from 2001 to 2003, HBV vaccine transported from the national vaccine store to provincial stores and from two provincial stores to rural health centers was monitored for freezing using 3M Freeze Watch(TM) indicators.Results. Of 181 provincial-to-rural transports, 19% (95% CI 13-25%) resulted in freezing. One of 59 or 1.6% (95% CI 0-5.6%) of national-to-provincial store transports indicated freezing. In the second half of each substudy, freezing events diminished. Duration of transport was associated with freezing.Conclusion. Identification of freezing temperatures during provincial-to-rural vaccine transport provides evidence that HBV vaccine is being damaged. This is the likely cause of the poor vaccine response in the Mongolian countryside. The authors speculate that packing vaccines for transport with ice taken directly from storage deep freezes at -20degreesC is the cause of the freezing. (C) 2004 The Institute For Cancer Prevention and Elsevier Inc. All rights reserved.