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The vaccine vial monitor: the world's smartest sticker

November 6, 2017 by Tom Furtwangler

03761_hr Lab workers in the Bandung BioFarma facility in Indonesia examine vials that have vaccine vial monitor technology incorporated into their labels.

Lab workers in the Bandung BioFarma facility in Indonesia examine vials that have heat-sensitive vaccine vial monitor technology incorporated into their labels. Photo: Umit Kartoglu.

Vaccine vial monitors flag heat-damaged vaccine

Imagine the challenge of getting the heat-sensitive polio vaccine from a high-tech pharmaceutical company in Belgium to a remote village in Ghana. The vaccine leaves by truck, is flown to Africa, and then is carried across dirt roads by vehicle, motorbike, or even bicycle to eventually reach a refrigerator in a rural clinic that has sporadic electricity. The journey may take days or weeks, during which the vaccine is constantly at risk of being exposed to too much heat, sapping its potency.

Too often in the past, health workers tossed out viable vaccines because they suspected damage from overheating, but had no way to confirm it. This additional cost of wasted vaccine vials can have a large impact on under-resourced national vaccine programs. Or, even worse, sometimes heat-exposed vaccines were used, and provided no protection to those who were immunized.

A small circle with a big impact

PATH recognized the scale of the problem, and starting in the late 1970s, worked with the World Health Organization (WHO) and a variety of technology partners to find a way to track the heat exposure of individual vaccine vials. In the early 1980s we teamed up with the Temptime Corporation to develop temperature-sensitive VVM stickers. In 1996, VVMs became commercially available for oral polio vaccine, adding only a few cents to the price of each vial.

Today, WHO requires that all vaccines purchased through the United Nations Children’s Fund (UNICEF) use VVMs. And together, WHO and UNICEF have urged other groups that procure vaccines—including donor agencies, international organizations, and country leaders—to make sure VVMs are required in all of their vaccine purchase agreements and donations.

In the years since introduction, the VVM has demonstrated its value again and again. In one example, electricity went out at health facilities in Yogyakarta, Indonesia, for several days during an earthquake. Vaccine vial monitors showed that most vaccines were undamaged, despite the heat, saving 50,000 doses of vaccine that otherwise would have been thrown away.

Medical equipment and vaccines are prepared for the Japanese Encephalities campaign in Xieng Khouang province, Laos.

Medical equipment and vaccines are prepared for a Japanese Encephalitis vaccination campaign in Xieng Khouang province, Laos. Photo: PATH.

Saving lives and resources

Today, many years after the first vaccine vial monitors transformed the transport, storage, and use of vaccines, the little color-changing circles continue to serve communities worldwide. They are on every vial of the MenAfriVac® vaccine, for example, helping to protect millions of people in sub-Saharan Africa against deadly meningitis A.

Over the next decade, it’s estimated that VVMs will allow workers to recognize and replace more than 200 million doses of damaged vaccine and to confidently deliver more than a billion more doses in remote settings—saving lives and reducing illness for countless people.

In addition, thanks to the presence of the VVMs on vaccines, WHO revised its policies to allow open vials of liquid vaccine to be used for more than a single day. UNICEF and WHO estimate that the use of VVMs on basic vaccines saves the global health community more than $14 million each year by preventing undamaged vaccines from being discarded.

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