Vaccines ruined by poor refrigeration

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Vaccines ruined by poor refrigeration

DES MOINES, Iowa - Every year, thousands of American children go through

the tearful, teeth-gritting ordeal of getting their vaccinations, only to

be forced to do it all over again. The vaccines were duds, ruined by poor

refrigeration.

It is more than a source of distress for parent and child. It is a public

health threat, because youngsters given understrength vaccines are

unprotected against dangerous diseases. And it accounts for a big part of

the $20 million in waste incurred by the federal Vaccines for Children

program.

" This is a substantial problem that needs to be addressed through

prevention, and when problems are discovered, often times through

revaccinations, " said Dr. Lance Rodewald, director of immunization services

at the Centers for Disease Control and Prevention in Atlanta.

By CDC estimates, hundreds of thousands of doses of vaccines against such

diseases as flu, diphtheria, tetanus, whooping cough, polio, mumps,

measles, chicken pox and the cervical cancer virus are thrown out each year

because of poor refrigeration at clinics, hospitals and doctors' offices.

In one recent case in Sioux City, Iowa, more than 1,000 families were

notified by letter and telephone that they needed to get their children

revaccinated. State officials found that the refrigerator at the clinic

that administered the shots repeatedly dropped below freezing over a

17-month period in 2005 and 2006, potentially ruining the vaccines stored

there.

" We just didn't notice it, " said Dr. Ray Sturdevant, president of the

Prairie Pediatrics and Adolescent Clinic.

Poor refrigeration has been blamed for similar problems elsewhere around

the country over the past 2 1/2 years:

• In St. Cloud, Minn., a clinic had to revaccinate 8,600 patients, most of

them children.

• In Lane County, Ore., 500 children and adults had to get another shot.

• In western Florida, it happened to about 250 kids.

In Sioux City and other cases, the spoilage resulted from a combination of

factors: The refrigerator malfunctioned or was not set or maintained at the

proper temperature — a problem that can be caused simply by leaving the

door open for a while — and the workers responsible for regularly logging

the temperature did not seem to recognize when the readings were off.

" We do everything we can to advise and to make people aware that this is

very expensive vaccines they're dealing with and we really want to handle

it properly and store it properly to prevent these things from happening —

but they do, " said , chief of immunization with the

Florida Health Department.

Inadequate refrigeration can cause vaccines to lose their potency, although

experts say spoiled childhood vaccines are not dangerous in themselves if

given to a youngster.

And there are no known cases of children contracting a disease because they

had been given a vaccine rendered ineffective by poor refrigeration. But it

could happen, and " that's why we're concerned about it, " Rodewald said.

Since 2000 the CDC has pushed state health departments to visit clinics and

check their refrigerators. Most states require clinics to use refrigerators

with reliable thermometers that can be monitored, and staff members must

know what to do when temperatures are above or below the proper range,

Rodewald said.

Waste costs the $2 billion-a-year federal Vaccines for Children Program

about $20 million a year, and the biggest single problem is improper

refrigeration, Rodewald said. Other causes: The vaccines expire or were

damaged in shipment.

Rodewald had no breakdown of how much in waste is attributable to poor

refrigeration. But he emphasized that the losses amount to an extremely

small percentage of the childhood vaccine program.

" The childhood program saves $10 billion each year in direct health care

costs by preventing disease among children, " he said. " Although preventing

vaccine wastage is a priority, the amount wasted should be placed in the

context of the overall program economic benefits. "

Altogether in 2006, there were 32 instances in Iowa in which vaccines were

not refrigerated correctly, said Dr. Quinlisk, state

epidemiologist. Quinlisk would not say how many patients were affected, but

estimated $750,000 worth of vaccine in the Vaccine for Children Program was

wasted.

" We will get months and months and months of vaccine refrigerator logs

where the refrigerator is out of the temperature and nobody has done

anything except every day mark down it's out of temperature, " she said.

In the Minnesota case, the refrigerator was not kept at the proper

temperature and there were gaps in documentation, said Jill Marette of the

Minnesota Department of Health.

" It's stressful to vaccinate your children in the first place — just the

idea of giving them all those shots. Then you have to think about getting

revaccinated, " Marette said.

Of greatest concern is the chickenpox vaccine. It must be kept frozen at an

average temperature of 5 degrees or lower and should be kept in the dark.

Children who receive an ineffective vaccine could easily become infected

because the disease is fairly common in the U.S.

Dr. ph Bocchini, chairman of the Committee on Infectious Diseases with

the American Academy of Pediatrics, said his group and others have issued

clear recommendations about storing vaccines, and refrigerators can be

equipped with alarms that sound when the temperature goes out of range.

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Sheri Nakken, former R.N., MA, Hahnemannian Homeopath

Vaccination Information & Choice Network, Nevada City CA & Wales UK

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