23

3.6 Indicator A B Indicator C D

6 10C 10 OPV, , MMR
DTP BCG 3 dT TT
6

3.7 Indicator A, B C D 7
10C 12 OPV, , MMR DTP BCG
3 dT TT
7

3.8 Indicator A, B, C D 8 10C

14 34C 2
8

24

9 VCCM 3

VCCM

25

DTP/TT/dT/HB

Alum DTP, dT, TT HB

( 0c)

( 4-8C)

( 0C)

1.

2.
15

3.
30

4.
1

26

(lot release)




1) (AEFI)

AEFI

BCG
DTP
dT
TT
DTP-Hep B
OPV
M
MMR
JE
Hep B

./
30/2,000
35/10,000
35/3,500
35/3,000
35/43,200
10/4,500
10/1,000
10/4,500
25/14,000
15/32,000

./
45/1,800
25/1,800
25/1,800
25/1,800
25/4,000
20/1,000
20/1,800
20/1,800
20/4,500
25/3,500

./
25/500
20/1,800
20/1,800
20/1,800
20/1,800
20/500
20/500
20/1,500
10/1,500

./
100/4,300
80/13,600
80/7,100
80/6,600
80/49,000
30/5,500
50/3,300
50/6800
60/20,000
50/37,000

40
60
60
60
60
60
40
60
60
60

27

(
)
(OPV)

()

2)


(Vaccine potency testing)

MMR

20,000
200,000
20,000
50,000
10,000

20
20
20
20
20

1
3
3
3
3

1. 5

2.
3. /
4.
5.

28

.......................................................


.................................................. /....................................................
. ......................................................................................./..............................
/........................................................................................ .............................
..........................................................................................

: ...........................................................................................................................
............................................................................................................................
Lot No............................................
..........................................................................................................
...........................................................................................................

........................................................................

1
............................................
(
)
..........................................................

29

, ,
,



1. (incinerator)
2.

3.

3.1 (Sterilization)
3.1.1 (moist heat)
(autoclave) 15 121
15 - 17
3.1.2 (hot air, dry heat)
(hot air oven) 150 2 160
2
3.2
20 (Disinfection)
3.3


Alcohols 2 ethanol isopropanol intermediate - level
disinfectant

30

- Ethanol 70% 20 20% Formalin

30
- Isopropanol 70 - 100% 20
ethanol
Aldehydes

2 Formaldehyde Glutaraldehyde high - level

disinfectant

(Alkylation)
- Formaldehyde formalin formaldehyde 37%
4% formaldehyde 24 8%
formaldehyde 18
- Glutaraldehyde Cidex glutaraldehyde 2%
70% isopropanol
glutaraldehyde 2% 10
(chemical sterilant)
,
Hydrogen Peroxide (H2O2) high-level disinfectant
paracetic acid

hydroxyl radical

H2O2 6% 30 high-level disinfectant

()


Chlorophors

- Sodium hypochlorite (NaOCI) intermediate-level disinfectant
Modified Dakin (NaOCI 0.5%) Chlorox, Virkon Virulex

0.5 % 5,000 ppm 30

/




()/
( 4-8C)


4-8C ()


. 




4-8C


()



- 


(1)

31

* 


.

- 
/ 4-8C


4-8C

/ 



- 
/ 4-8C
- / 


- 

- 

3 

3 *

. / . / .

- . 

. 
( 


)




(2)

- 
. 


32

- 
4-8C

3 

. 





- 
4-8C
- 

* 

- 

- 

3 *

(3)

33

34

1.

1.1
-
- 1
(Refrigerator)

-
./PCU 5
./. 5 - 10
. 10

- . /. / .
1
24 x 36
-

-
-
-

4-8c
( 2 )
-

-
Breaker

* -
-
15
-
- R134 a
1.2

(Cold box)

1.3

(Vaccine
Carrier)

-
- 1 (

4-8c 24 .)
-
- 5
-
-

-
- 4 - 8c 24 .

1.4 -
-

(Thermometer)
-

1.5
(Ice pack)

- ./PCU 4
- . / . 8
- . 16
- 90 %

-

2.

2.1

- 1 1
-

-

-
-

-
-

-
(Ms./Mrs./Mr.Coldchain)
-
6 - 12
-
( 90 )
-

-
-
- /

- 4

35

Hospital Accreditation

36

- 5 .
(freezer)
-
- 2 - (08.30 .
16.30 .) (
47)

2.2

- - -
-
-
-
-
-

2.3

- - -
-
-
-
-

2.4

- -

2.5 - - -
- 90%

-
- ()
3.

(././PCU)
-
-
-
-
-

- DTP, dT, T, HB JE ()
-
4 - 8c

- OPV
- MMR JE ()
4 - 8c

-
-

4.

4.1

4.2

-
- 1-2
-

- -
-

-
-

- .3 .3/1

- -

4.3 -

5.

37

.3/1

- 3

- 3

4 - 8c
- -

32

6.

38

39

.3

.....................................

................................
................................................

................................................
.............................................................................

1
2
3
4
5
6
7
8
9
10
11
12

()

()

()

()
()

()

()
()

()
- ()
()
()

(............................................)
.............................................

Lot no.
Expiry Date

()
()

()

()

()

()
MMR
()

()

-
()
()
()
()

.............
...................................................................

40

41

.4

...............................................................................................................................................................
/...........................................................................................................................
. ................................................ ...............................................................................

()

.
1
..........................
..........................
2

..........................
..........................
3
..........................
..........................
4

..........................
..........................
5

..........................
..........................
6

..........................
..........................
7

..........................
..........................
8

..........................
..........................
9

..........................
..........................
10

..........................
..........................
11
..........................
..........................
12

..........................
..........................
13
- ..........................
..........................

.................................................................................
............ .................... ............................................

15

.....................................................................................

42

.................................................... .........................

(.) (.)
(., . CUP) (. / PCU / . / )
( / / ) 3 1

43

.........

.......................................................... .........................................................................
........................................... .................................................
//

44

.3/1

...........................................

....................................
....................................................

................................................
.............................................................................
.......................
.................

()

() () () ()
1. BCG
-
- . 1
2. HB
3. DTP
4. OPV
- < 5
- . 1
5. M
6. JE
7. MMR
8. dT
- . 1
- . 6
9. T
10 DTP-HB
1. = -
2.
= () - x 100
()
3. = x

(..........................................)
..................................................

45

.3/1

.....()
1. ()

2. ()
-
( 46)
100 X
() =
(100 - ) X
1 12 HB
10% 2 doses/
100 X 12
() =
= 6.67 = 7
(100-10) X 2
-

-
. .....( )
1. () /

2. ()

3.

() -
X 100
()
() = X

46

BCG

.1
< 1
< 5
< 1
< 5
.1
< 1
< 3
.1
.1,.6

HB
DTP
DTP-HB
OPV
M
JE
MMR
dT
T

()
50
10
10
25
25
25
10
25
10
10
10
25

/
10
10
2
10
10
20
20
10
2,4
10
10
10

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31

16.30 .

<-8 -8 -7 -6 -5 -4 -3 -2 -1 0 1 2 3 4 5 6 7 8 9 >9

08.30 .
<-8 -8 -7 -6 -5 -4 -3 -2 -1 0 1 2 3 4 5 6 7 8 9 >9

....................... ..........................................

47

1. 1.

2.
- Vaccine

1.
1.
1./
1.
Vaccine

1 2.

2. 2.

2.
3.

5%
8
1
3.

4.
-

. 4

48

1. -

1.
2.

3.

4.

1.

2.

1.
1.

2

2.

2.
3.

4.

5.

. 4

49

1 2
+
+
+
+
+
+
1 2
4c 4c
5c 3c

3
+
+
+
+
+
+
3
4c
4c
4 5 6
+
+
+
+
+
+
4 5 6
5c 4c 4c
6c 4c 4c
7
+
+
+
+
+
+
7
4c
5c
8
+
+
+
+
+
+
8
4c
5c
9
+
+
+
+
+
+
9
4c
4c
10
+
+
+
+
+
+
10
4c
5c
11 12 13
+
+
+
+
+
+
11 12 13
5c 4c 4c
5c 5c 5c
14
+
+
+
+
+
+
14
4c
5c
15
+
+
+
+
+
+
15
3c
4c
16
+
+
+
+
+
+
16
4c
5c
17
+
+
+
+
+
+
17
5c
5c
18 19 20
+
+
+
+
+
+
18 19 20
4c 4c 4c
3c 4c 5c

4
......2546......2546

21
+
+
+
+
+
+
21
4c
4c
22
+
+
+
+
+
+
22
4c
4c
23
+
+
+
+
+
+
23
4c
4c
24
+
+
+
+
+
+
24
4c
4c

25 26 27
+
+
+
+
+
+
25 26 27
4c 4c 4c
5c 4c 4c

28
+
+
+
+
+
+
28
4c
4c

29
+
+
+
+
+
+
29
3c
4c

30
+
+
+
+
+
+
30
4c
4c

50

 1
2 2544
2 2544
2 2544

23 2544
23 2544
23 2544
15
15
15
15
29
29
29
29

2545
2545
2545
2545
2545
2545
2545
2545

2
8 2544
8 2544
8 2544

8 2545
8 2545
8 2545
3
19 2544
19 2544
19 2544

10 2545
10 2545
10 2545
23
23
23
23
30
30
30
30

2545
2545
2545
2545
2545
2545
2545
2545

4
29 2544
29 2544
29 2544

23 2545
23 2545
23 2545

..
..
..
..
..
..
..
..
..
..
..
..
5 12 18 26 9 16 23 30 7 14 21 28 4 11 18 25 1 8 15 22 8 15 22 29 5 12 19 26 10 17 24 31 7 14 21 28 5 12 19 26 9 6 23 30 6 13 20 27

5 12 18 26 9 16 23 30 7 14 21 28 4 11 18 25 1 8 15 22 8 15 22 29 5 12 19 26 10 17 24 31 7 14 21 28 5 12 19 26 9 6 23 30 6 13 20 27

3 6
- 2544
- 2545
- 2545
- 2545

30 2544
15 2545
17 2545
16 2545

30 2544
15 2545
17 2545
16 2545
12

30

51

52

1. , , .
, 1 : ,
2538.
2. , , . ,
9 : 2543
3. , , .
, 1 :
(.), 2546.
4. . . . :
, .. 2540.
5. . . : , ,
, , . . 4, :
, .. 2539 566-78
6. . . : .. ,
.. 2541 147 - 67.
7. http :// www.who.int/vaccines-access/vacman/temperature/temperature.htm
8. http :// www.who.int/vaccines-access/vacman/reconst/vaccinereconstitution.htm