An essential part of deploying any vaccine is making sure the vaccine vials can be kept at the necessary temperatures while stored at and transported between national and local storage or health-care facilities. To strengthen Azerbaijan’s national vaccine cold chain system, the WHO Country Office in Azerbaijan has in the past year facilitated the procurement of cold chain equipment, including fridges and vaccine carriers, and trained local health-care staff on the use of the equipment and what procedures to initiate in different scenarios. Participants have included representatives from hygiene and epidemiology centres, health-care facilities and national health partners.
The most recent training, conducted in December 2022, focused on a small but critical device called Fridge-Tag. The Country Office has procured 2100 of these temperature-monitoring devices for Azerbaijan under the European Union (EU)-funded programme supporting an effective COVID-19 vaccination rollout and strengthening immunization systems in the EU’s Eastern Partnership region.
Providing health workers with the information they need
Fridge-Tag continuously measures vaccine storage temperatures and immediately issues an alert when a set temperature limit has been exceeded. These devices have been installed in vaccine storage facilities across the country.
“The equipment greatly strengthens Azerbaijan’s cold chain system, because health workers are no longer limited to spot checks with a thermometer, which only informs about the temperature at the time of the reading; this equipment can instead access the last 30-days of temperature recordings as well as the duration of any alarm if triggered,” explains Dr Erida Nelaj, from WHO/Europe, who led the training sessions.
This allows health workers to see any temperature excursions outside the recommended ranges throughout the day or night or during their absence, including holidays and weekends.
Temperature conditions within a cold room or refrigerator can fluctuate; for example, due to an accidental interruption of the electricity supply, improper storage practices or exposure to direct sunlight. Thanks to Fridge-Tags, health workers can act on any potential breaches in the cold chain, alerting supervisors or other departments as necessary and triggering the appropriate corrective measures to reduce and/or eliminate cold chain problems.
Dr Nelaj also highlights that the Fridge-Tags’ alarms cannot be tampered with, and the devices cannot be reset. This guarantees the trustworthiness and accuracy of the gathered data, which is retained for 60 days and can be retrieved by simply downloading it. The quality of the data also enables health workers to determine whether any vaccines may have been compromised.
What is a cold chain system?
A temperature-controlled supply chain (or cold chain) includes a set of rules and procedures for proper storage and transport of vaccines, along with an uninterrupted chain of refrigeration equipment.
“Unless certain conditions are maintained consistently, vaccines risk losing potency, or can even be rendered entirely ineffective, resulting in inadequate immune responses in recipients and poor protection against the targeted disease. The benefits of immunization coverage efforts are therefore jeopardized if people are administered damaged vaccines that have insufficient potency to give the necessary protection,” explains Dr Sevinj Hasanova, National Professional Officer on Immunization at the WHO Country Office in Azerbaijan.
The majority of vaccines must be stored between 2⁰C and 8⁰C, while some must remain frozen in a range between -15⁰C and -50⁰C until shortly before use. Temperature monitoring is critical to ensure that vaccines are kept at the correct temperature and that any change in temperature does not go unnoticed.
“But even the most expensive and sophisticated equipment will not ensure an effective cold chain if it is not used and managed correctly by health personnel,” emphasizes Dr Hasanova, who organized the training.
Partnering with the EU has strengthened Azerbaijan’s immunization services
Since the start of the programme in 2021, the WHO Country Office in Azerbaijan has procured 300 vaccine refrigerators and 2100 Fridge-Tags, supplying health workers with critical equipment. In addition, over 70% of the country’s health workers involved in the vaccination process have been trained on various aspects of vaccine deployment, for both COVID-19 and routine vaccines.