🎯 High-yield for Nursing Competitive Exams
📝 Presented in your preferred style — Clear, Visual & MCQ-Ready
🔹 Immunity is the body’s defense mechanism to protect itself against harmful agents like bacteria, viruses, fungi, and toxins.
🔹 It involves the recognition and destruction of foreign substances (antigens).
🧠 Given by scientists Paul Ehrlich & later expanded in modern immunology
🔹 Present from birth
🔹 Provides immediate defense
🔹 Acts against all pathogens in the same way
💡 Examples:
👩⚕️ Nursing Role:
🔹 Develops after exposure to antigens
🔹 Has memory cells → faster response upon re-exposure
🔹 Highly specific to each pathogen
🧠 Immune system is stimulated to produce antibodies
| Type | How It Occurs | Example |
|---|---|---|
| Natural Active | After natural infection | Chickenpox infection 🐔 |
| Artificial Active | After vaccination | MMR, Hepatitis B vaccines 💉 |
👩⚕️ Nursing Role:
🧠 No effort by immune system, short-term protection
| Type | How It Occurs | Example |
|---|---|---|
| Natural Passive | Antibodies via placenta/milk | Maternal IgG, IgA 🍼 |
| Artificial Passive | Injection of antibodies | Rabies immunoglobulin 🦇, Tetanus antitoxin |
👩⚕️ Nursing Role:
| Feature | Innate Immunity | Acquired Immunity |
|---|---|---|
| Onset | Immediate | Delayed |
| Specificity | Non-specific | Specific |
| Memory | No | Yes |
| Duration | Short | Long (active) |
| Examples | Skin, NK cells | Antibodies |
“In Active immunity — I make Antibodies”
“Passive = Preformed antibodies Pushed in”
✅ Q: Breast milk provides which type of immunity?
🅰️ Natural Passive Immunity
✅ Q: Which immunity has memory cells?
🅰️ Acquired (Active) Immunity
✅ Q: Rabies immunoglobulin is what type of immunity?
🅰️ Artificial Passive Immunity
✅ Q: Skin is part of which type of immunity?
🅰️ Innate Immunity
✅ Q: Chickenpox infection leads to which immunity?
🅰️ Natural Active Immunity
🔹 Immunoglobulins (Ig) are glycoproteins produced by B-lymphocytes (plasma cells) in response to antigens (foreign substances).
🔹 They are also called antibodies and are key players in adaptive (acquired) immunity.
🔸 Shaped like ‘Y’
🔸 Composed of:
| Type | % in Serum | Key Functions |
|---|---|---|
| 🅰️ IgA | ~15% | Mucosal defense (secretions: tears, saliva, milk) |
| 🅱️ IgG | ~75% | Main antibody in blood, crosses placenta |
| 🅲️ IgM | ~10% | First antibody produced during infection |
| 🅳️ IgE | <1% | Allergy & parasitic defense |
| 🅴️ IgD | <1% | Role in B-cell activation |
🔹 Most abundant in plasma
🔹 Only antibody that crosses placenta
🔹 Provides long-term immunity
💡 Examples: Post-vaccination, maternal antibody in fetus
👩⚕️ Nursing Relevance: Passive immunity to newborn via placenta
🔹 Found in secretions: saliva, tears, sweat, breast milk, GI & respiratory tract
🔹 First line of defense in mucosal immunity
💡 Examples: Gut immunity, breastfeeding
👩⚕️ Nursing Relevance: Supports neonatal immunity via colostrum
🔹 First antibody formed after antigen exposure
🔹 Largest in size, cannot cross placenta
🔹 Indicates recent infection
💡 Examples: Early phase of Hepatitis B infection
👩⚕️ Nursing Relevance: Diagnostic marker for acute infection
🔹 Involved in allergic reactions and defense against parasitic infections
🔹 Binds to mast cells → releases histamine
💡 Examples: Asthma, eczema, anaphylaxis
👩⚕️ Nursing Relevance: Monitor for hypersensitivity and anaphylactic shock
🔹 Found on surface of B cells
🔹 Helps in B-cell activation
🔹 Function not fully understood
💡 Examples: Marker in early B cell maturation
🔹 G = IgG → General (blood & placenta)
🔹 A = IgA → Airways & Secretions
🔹 M = IgM → Main in acute infection
🔹 E = IgE → Eosinophils, Allergy
🔹 D = IgD → Development of B-cells
✅ Q: Which immunoglobulin crosses the placenta?
🅰️ IgG
✅ Q: Which antibody is first produced after infection?
🅰️ IgM
✅ Q: Which antibody is predominant in secretions?
🅰️ IgA
✅ Q: Immunoglobulin involved in allergic reactions?
🅰️ IgE
✅ Q: Which antibody helps in B-cell maturation?
🅰️ IgD
🔹 Immunizing agents are biological substances that stimulate the immune system to produce protective immunity against infectious diseases.
🔹 They can prevent, control, or treat infections by preparing the body to fight future exposures.
🛡️ Goal: To develop active or passive immunity.
| Category | Type | Action | Example |
|---|---|---|---|
| 🔹 Vaccines | Live attenuated | Mimic infection → strong response | BCG, MMR, OPV |
| Inactivated (killed) | Safer, weaker response | IPV, Hepatitis A | |
| Subunit/Conjugate | Use parts of pathogen | Hib, HPV, Pneumococcal | |
| Toxoid | Inactivated toxin → immune response | Tetanus, Diphtheria | |
| 🔹 Antisera | Ready-made antibodies | Passive immunity | Tetanus antiserum |
| 🔹 Immunoglobulins | Preformed antibodies (IgG) | Passive immunity | Rabies Ig, Hepatitis B Ig |
| 🔹 Monoclonal Antibodies | Targeted lab-made Ig | Passive, specific | Palivizumab (RSV) |
| Immunity Type | Agent Examples |
|---|---|
| Active Immunity | Vaccines (e.g., MMR, DPT, Hep B) |
| Passive Immunity | Antisera, Immunoglobulins |
| Vaccine | Prevents |
|---|---|
| BCG | Tuberculosis 🦠 |
| OPV/IPV | Polio 🧠 |
| DPT | Diphtheria, Pertussis, Tetanus 💉 |
| Hepatitis B | Hepatitis B Virus 🦠 |
| MMR | Measles, Mumps, Rubella 😷 |
| Hib | Haemophilus influenzae B |
| TT (Tetanus Toxoid) | Tetanus (for pregnant women & injuries) |
| JE Vaccine | Japanese Encephalitis (endemic areas) |
🔹 Educate parents/patients about vaccines
🔹 Maintain cold chain (2°C–8°C)
🔹 Follow National Immunization Schedule
🔹 Monitor for adverse reactions (e.g., anaphylaxis)
🔹 Keep accurate vaccination records
🔹 Manage and report Adverse Events Following Immunization (AEFI)
🔹 BCG is given intradermally at birth
🔹 OPV is oral
🔹 MMR is subcutaneous
🔹 DPT and Hepatitis B are intramuscular
🔹 TT is given during pregnancy (2 doses)
✅ Q1. Which of the following is a live attenuated vaccine?
🅰️ MMR
✅ Q2. Which vaccine is given to prevent tuberculosis?
🅰️ BCG
✅ Q3. Immunoglobulins provide which type of immunity?
🅰️ Passive Immunity
✅ Q4. Cold chain temperature range is —
🅰️ 2°C to 8°C
✅ Q5. TT is given in which route?
🅰️ Intramuscular
“Very Active Soldiers Instantly Guard People”
🔸 Vaccines
🔸 Antisera
🔸 Subunit
🔸 Inactivated
🔸 Globulins
🔸 Passive (MonoClonal Ig)
🔹 A vaccine is a biological preparation that provides active acquired immunity to a particular infectious disease.
🔹 It contains weakened or inactivated forms of pathogens, their toxins, or parts (like proteins) which stimulate the immune system to produce antibodies.
🛡️ Purpose: Prevent infections by training the body to recognize and fight pathogens in the future.
| Type | Content & Mechanism | Examples |
|---|---|---|
| 1️⃣ Live Attenuated | Weakened form of live pathogen | BCG, MMR, OPV, Yellow Fever |
| 2️⃣ Inactivated (Killed) | Dead pathogens, unable to replicate | IPV, Rabies, Hepatitis A |
| 3️⃣ Toxoid | Inactivated toxins of bacteria | Tetanus toxoid (TT), Diphtheria toxoid |
| 4️⃣ Subunit/Conjugate | Only parts (protein/sugar) of the pathogen | Hepatitis B, HPV, Hib, Pneumococcal |
| 5️⃣ mRNA Vaccine | Uses messenger RNA to produce antigen protein | Pfizer, Moderna (COVID-19) |
| 6️⃣ Viral Vector Vaccine | Uses a harmless virus to deliver genetic material | Covishield (Oxford-AstraZeneca), Sputnik V |
✔️ Strongest immune response
✔️ Often need only 1–2 doses
❌ Not safe for immunocompromised or pregnant women
Examples:
✔️ Safe for all (no replication)
❌ Require multiple doses/boosters
Examples:
✔️ Neutralizes bacterial toxins, not bacteria
✔️ Produces antitoxin antibodies
Examples:
✔️ Safer, uses specific parts of pathogen
✔️ Good for infants & immunocompromised
Examples:
✔️ Teaches cells to make viral proteins → immune response
✔️ No live virus used
Examples:
✔️ Uses modified viruses as vectors to deliver gene
✔️ Strong immune response
Examples:
✅ Q: Which vaccine is live attenuated?
🅰️ MMR, BCG, OPV
✅ Q: Which vaccine is safe in pregnancy – live or inactivated?
🅰️ Inactivated
✅ Q: Which vaccine neutralizes bacterial toxins?
🅰️ Toxoid vaccines
✅ Q: Which type of vaccine is Covishield?
🅰️ Viral vector vaccine
✅ Q: Which vaccine contains only the antigenic part of pathogen?
🅰️ Subunit/Conjugate vaccine
🔹 L – Live attenuated
🔹 I – Inactivated
🔹 T – Toxoid
🔹 S – Subunit
🔹 V – Viral vector
🔹 M – mRNA
🔹 An immunization program is a planned, systematic public health strategy to provide vaccines to prevent infectious diseases, especially in children and vulnerable groups.
🔹 It helps in achieving herd immunity and disease eradication.
✔️ Reduce morbidity and mortality due to vaccine-preventable diseases
✔️ Improve child survival rate
✔️ Achieve universal vaccine coverage
✔️ Eliminate/eradicate diseases like polio, measles, tetanus
🔹 Launched by WHO in 1974
🔹 Aim: To ensure universal access to six basic vaccines
🔹 Focus: Infants and women of reproductive age
📌 Target Diseases (Original):
🗓️ Launched in 1985
🔹 Largest public health program in India
🔹 Provides free vaccination to all eligible children and pregnant women
🔹 Covers 12 vaccine-preventable diseases now
| Age/Target Group | Vaccine Name | Disease Prevented |
|---|---|---|
| At birth | BCG, OPV-0, Hep B-0 | TB, Polio, Hepatitis B |
| 6, 10, 14 weeks | DPT, OPV, Hep B, Hib, IPV | Diphtheria, Pertussis, Tetanus, etc. |
| 9 months | Measles-Rubella (MR) | Measles & Rubella |
| 9-12 months | JE vaccine (in endemic areas) | Japanese Encephalitis |
| 16–24 months | Booster doses: DPT, MR, OPV | Boost immunity |
| 5–6 years | DPT booster | School-age protection |
| 10 & 16 years | Tetanus Toxoid (TT) | School health |
| Pregnant women | TT or Td (2 doses) | Maternal & neonatal tetanus prevention |
🚀 Special drive to increase full immunization coverage
🎯 Target: Reach 90% immunization of all children and pregnant women
💡 Tagline: “Let every child be vaccinated – Every child protected.”
| Program Name | Focus |
|---|---|
| Pulse Polio Program | Polio eradication with OPV drops |
| Intensified Mission Indradhanush (IMI) | Accelerated coverage in high-risk areas |
| COVID-19 Vaccination Program | National vaccination drive against COVID-19 |
✔️ Maintain cold chain (2–8°C)
✔️ Administer vaccines as per National Immunization Schedule
✔️ Identify & mobilize target beneficiaries
✔️ Educate about importance of vaccines
✔️ Manage and report AEFI (Adverse Events Following Immunization)
✔️ Record-keeping and follow-up
✅ Q: Which year was UIP launched in India?
🅰️ 1985
✅ Q: What is the aim of Mission Indradhanush?
🅰️ Increase full immunization coverage to 90%
✅ Q: Which vaccine is given at birth under UIP?
🅰️ BCG, OPV-0, Hep B-0
✅ Q: Temperature range of vaccine storage?
🅰️ 2°C to 8°C
✅ Q: Pulse Polio Program uses which vaccine?
🅰️ OPV (Oral Polio Vaccine)
🔸 BCG
🔸 Hepatitis B
🔸 DPT
🔸 Measles
🔸 Japanese Encephalitis
🔸 Subunit (Hib)
🔸 TT
🔸 Polio (OPV/IPV)
🔸 Newborn Vaccines
| 🧪 Vaccine Name | 👶 Age/When Given | 💉 Dose & Route | 📍 Site of Administration | 🛡️ Disease Prevented |
|---|---|---|---|---|
| BCG | At birth | 0.1 ml, intradermal | Left upper arm | Tuberculosis 🦠 |
| Hepatitis B-0 | At birth (within 24 hrs) | 0.5 ml, intramuscular | Anterolateral thigh (right) | Hepatitis B 🦠 |
| OPV-0 | At birth | 2 drops, oral | Oral (mouth) | Polio 🧠 |
| OPV-1,2,3 | 6, 10, 14 weeks | 2 drops, oral | Oral | Polio 🧠 |
| IPV-1,2 | 6, 14 weeks | 0.5 ml, intramuscular | Anterolateral thigh (right) | Polio (inactivated) 🧠 |
| Pentavalent (DPT + Hep B + Hib) | 6, 10, 14 weeks | 0.5 ml, intramuscular | Anterolateral thigh (left) | Diphtheria, Pertussis, Tetanus, Hep B, Hib |
| Rotavirus | 6, 10, 14 weeks | 5 drops, oral | Oral | Diarrhea (Rotavirus) 💦 |
| Pneumococcal Conjugate Vaccine (PCV) | 6, 14 weeks, 9 months | 0.5 ml, intramuscular | Anterolateral thigh | Pneumonia, Meningitis |
| MR (Measles-Rubella) | 9-12 months & 16-24 months | 0.5 ml, subcutaneous | Right upper arm | Measles & Rubella 😷 |
| JE (SA-14 strain) | 9-12 months & 16-24 months (endemic areas) | 0.5 ml, subcutaneous | Left upper arm | Japanese Encephalitis 🧠 |
| Vitamin A | With 1st MR dose at 9 months | 1 ml, oral | Oral | Prevents Vitamin A deficiency 👁️ |
| DPT Booster-1 | 16-24 months | 0.5 ml, intramuscular | Anterolateral thigh | Diphtheria, Pertussis, Tetanus 💉 |
| OPV Booster | 16-24 months | 2 drops, oral | Oral | Polio 🧠 |
| MR-2 | 16-24 months | 0.5 ml, subcutaneous | Right upper arm | Measles & Rubella |
| JE-2 | 16-24 months (in JE areas) | 0.5 ml, subcutaneous | Left upper arm | Japanese Encephalitis |
| DPT Booster-2 | 5-6 years | 0.5 ml, intramuscular | Upper arm | Diphtheria, Pertussis, Tetanus |
| TT or Td (10 & 16 yrs) | 10 and 16 years | 0.5 ml, intramuscular | Upper arm | Tetanus 🛡️ |
| TT for Pregnant Women | 1st dose – early pregnancy, 2nd dose – after 4 weeks | 0.5 ml, intramuscular | Upper arm | Maternal & neonatal tetanus 💉 |
✔️ Maintain cold chain (2°C to 8°C)
✔️ Verify vaccine vial monitor (VVM)
✔️ Record batch number, site, date
✔️ Manage AEFI (Adverse Events Following Immunization)
✔️ Educate parents on vaccine importance & follow-up
✅ Q: Which vaccine is given intradermally?
🅰️ BCG
✅ Q: Which vaccine is given orally at birth?
🅰️ OPV-0
✅ Q: Which vaccines are given subcutaneously?
🅰️ MR, JE
✅ Q: Which vaccine prevents five diseases in one shot?
🅰️ Pentavalent
✅ Q: Where is the Hepatitis B vaccine given in infants?
🅰️ Right thigh (anterolateral)
🎯 Nursing Competitive Exam Goldmine – NORCET, NCLEX, AIIMS, RRB, NHM, etc.
🛡️ Protects against: Severe forms of TB (miliary & meningeal)
✅ Route: Intradermal
📍 Site: Left upper arm
💉 Dose: 0.1 ml (0.05 ml if <1 month old)
🧊 Storage: 2–8°C (reconstituted vaccine valid for 4–6 hrs)
🔔 Nursing Instructions:
🛡️ Protects against: Poliomyelitis
✅ Route: Oral
💧 Dose: 2 drops
🧊 Storage: +2 to +8°C, away from sunlight
🔔 Nursing Instructions:
🛡️ Protects against: Hepatitis B virus infection
✅ Route: Intramuscular
📍 Site: Right anterolateral thigh
💉 Dose: 0.5 ml
🧊 Storage: 2–8°C
🔔 Nursing Instructions:
🛡️ Protects against: Diphtheria, Pertussis, Tetanus, Hepatitis B, Haemophilus influenzae B
✅ Route: Intramuscular
📍 Site: Left anterolateral thigh
💉 Dose: 0.5 ml
🔔 Instructions:
🛡️ Protects against: Polio (inactivated form)
✅ Route: Intramuscular
📍 Site: Right thigh
💉 Dose: 0.5 ml
🔔 Instructions:
💧 Dose: 2 drops orally
📅 Given at: 6, 10, 14 weeks
🧊 Keep in cold chain – light-sensitive
🛡️ Protects against: Rotaviral diarrhea
✅ Route: Oral
💧 Dose: 5 drops
📅 At 6, 10, 14 weeks
🔔 Instructions:
🛡️ Protects against: Pneumonia, meningitis, otitis media
✅ Route: Intramuscular
📍 Site: Thigh
💉 Dose: 0.5 ml
📅 At 6, 14 weeks + booster at 9 months
🛡️ Protects against: Measles, Rubella
✅ Route: Subcutaneous
📍 Site: Right upper arm
💉 Dose: 0.5 ml
🔔 Instructions:
✅ Route: Subcutaneous
📍 Site: Left upper arm
💉 Dose: 0.5 ml
💉 Given at 9 months
✅ Same dose & route as primary
🛡️ Prevents: Night blindness
✅ Route: Oral
💉 Dose: 1 ml = 1 lakh IU
📅 Given with MR-1
📍 Upper arm
✅ IM route, 0.5 ml
📍 Right upper arm
✅ SC route, 0.5 ml
📍 Left upper arm
✅ SC, 0.5 ml
💧 2 drops orally
💉 2 ml = 2 lakh IU
📅 At 16–18 months
✅ IM route, 0.5 ml
📍 Upper arm
✅ IM route, 0.5 ml
📍 Upper arm
📅 At 10 and 16 years
💉 IM, 0.5 ml
📍 Upper arm
🔔 If fully vaccinated in last 3 years → only TT Booster
🔹 ✅ Maintain cold chain (2–8°C)
🔹 ✅ Check Vaccine Vial Monitor (VVM) before use
🔹 ❌ Do NOT freeze: Pentavalent, TT, IPV
🔹 ❌ Do NOT shake: PCV, TT
🔹 ⏳ Reconstituted vaccines must be discarded in 4–6 hours
🔹 🧼 Use separate sterile syringes for each vaccine
✅ Q. Which vaccine is given intradermally?
🅰️ BCG
✅ Q. Which vaccine is stored in frozen condition?
🅰️ OPV
✅ Q. Which vaccine is reconstituted and discarded within 4 hours?
🅰️ BCG, MR
✅ Q. What is the site of injection for pentavalent vaccine?
🅰️ Left anterolateral thigh
✅ Q. Which vaccines are given subcutaneously?
🅰️ MR, JE
Here is a 🌟 colorful, exam-focused, and easy-to-understand note on:
🔹 The Cold Chain is a temperature-controlled supply system used to store, transport, and distribute vaccines from the point of manufacture to the point of use without losing their potency.
🔹 It ensures vaccines remain safe, effective, and viable until administration.
✅ +2°C to +8°C for most vaccines
❌ Never freeze freeze-sensitive vaccines like:
| 🛠️ Component | 📌 Purpose | 📍 Level Used |
|---|---|---|
| Walk-in Cooler (WIC) | Bulk storage at state level | State vaccine stores |
| Ice Lined Refrigerator (ILR) | Stores vaccines at PHC/CHC | District/PHC/CHC level |
| Deep Freezer | Freezes ice packs and stores OPV | District & PHC level |
| Cold Box | Short-term vaccine transport | Between PHC to outreach |
| Vaccine Carrier | For carrying small quantities of vaccines | ANM/AWW during sessions |
| Ice Packs | Maintain cool temperature in boxes/carriers | All transport levels |
| Digital/Stem Thermometer | Monitors internal temperature | ILR, Cold Boxes |
| Vaccine Vial Monitor (VVM) | Shows heat exposure status of the vial | On every vaccine vial |
| ❄️ Freeze-Sensitive Vaccines | 🔥 Heat-Sensitive Vaccines |
|---|---|
| Pentavalent, DPT, TT, Hep B, IPV | BCG (after reconstitution), OPV, MR |
🧠 Mnemonic for Freeze-Sensitive:
“People Don’t Hate Ice”
🔸 A small label on vials that changes color with cumulative heat exposure
| Stage | Vial Use Status |
|---|---|
| Stage 1 & 2 | ✅ Safe to use |
| Stage 3 & 4 | ❌ Discard the vial |
🧠 Inner square darker than outer ring = Discard
🔹 Check & record temperature twice daily
🔹 Use first-expiry-first-out (FEFO) policy
🔹 Monitor VVM before administration
🔹 Keep vaccines away from walls of ILR (prevent freezing)
🔹 Do not keep vaccines in door/racks of domestic refrigerators
🔹 NEVER refreeze thawed ice packs
🔹 Educate about open vial policy
✅ Vaccines that can be used up to 28 days after opening if:
Applies to:
❌ NOT for:
✅ Q: What is the ideal temperature for vaccine storage?
🅰️ +2°C to +8°C
✅ Q: Which vaccine must never be frozen?
🅰️ Pentavalent
✅ Q: Which equipment is used by ANM for vaccine transport?
🅰️ Vaccine Carrier
✅ Q: Which monitor shows exposure to heat?
🅰️ Vaccine Vial Monitor (VVM)
✅ Q: How long can reconstituted BCG be used?
🅰️ 6 hours
Cold Chain Equipment refers to the devices and tools used to store, transport, and handle vaccines at safe temperatures (🧊 +2°C to +8°C) from manufacture to administration point without losing potency.
| 🛠️ Equipment | 📌 Purpose/Function | 📍 Level Used |
|---|---|---|
| 🏢 Walk-in Cooler (WIC) | Bulk vaccine storage (state/regional) at +2°C to +8°C | State vaccine store |
| 🧊 Ice-Lined Refrigerator (ILR) | Stores all vaccines (except those to be frozen) | District, CHC, PHC |
| 🧊 Deep Freezer (DF) | Freezes ice packs, stores OPV & BCG before reconstitution | District, CHC, PHC |
| 📦 Cold Box | Temporary storage/transport of vaccines during transit | Between PHC & outreach |
| 🧳 Vaccine Carrier | Carries small quantities of vaccines for immunization sessions | By ANM/ASHA |
| ❄️ Ice Packs | Maintain temperature in cold box & carrier | All levels |
| 🌡️ Stem/Digital Thermometer | To monitor the internal temperature of ILR/DF | Attached to ILR/DF |
| 🔘 Vaccine Vial Monitor (VVM) | Heat-sensitive label on vaccine vial showing exposure status | On each vaccine vial |
| 📋 Temperature Log Book | Records temperature twice daily | All cold chain points |
| 🔐 Domestic Refrigerator (limited use) | Used only with precautions (NOT preferred) | Sub-centers/emergency |
🔹 Check temperature twice daily (morning and evening)
🔹 Place thermometer centrally inside ILR
🔹 Record in temperature logbook
🔹 Do NOT store vaccines in door or bottom of ILR
🔹 Reconstituted vaccines (BCG/MR) must be used within 4–6 hours
🔹 Always check VVM (Vaccine Vial Monitor) before use
🔹 Never use domestic refrigerator for vaccines unless it’s emergency & strictly monitored
✅ Q1. Which equipment is used to freeze ice packs?
🅰️ Deep Freezer
✅ Q2. Which equipment is used by ANM in outreach sessions?
🅰️ Vaccine Carrier
✅ Q3. Which equipment stores vaccines at PHC level?
🅰️ Ice-Lined Refrigerator (ILR)
✅ Q4. What does VVM on a vaccine vial indicate?
🅰️ Cumulative heat exposure
✅ Q5. For how many hours can a cold box keep vaccines safe without opening?
🅰️ 24–72 hours
“WID C-C VIPT”
🔹 Reverse Cold Chain is the process of maintaining the required temperature (2°C to 8°C) while transporting biological specimens (especially stool samples for polio) from the field to the laboratory for diagnostic testing.
💡 It’s called “reverse” because unlike the cold chain (which moves vaccines from manufacturer → user), this moves specimens from field → lab.
✔️ To preserve viability of disease-causing organisms (like poliovirus) in the sample
✔️ To enable accurate lab diagnosis
✔️ Vital for disease surveillance (e.g., Acute Flaccid Paralysis – AFP)
| 🧫 Sample | 🦠 Disease Surveillance |
|---|---|
| Stool specimen | Poliomyelitis (AFP cases) |
| Blood samples | Measles, Rubella, COVID-19 (in some cases) |
✅ +2°C to +8°C
❌ Do NOT freeze samples
| 📦 Equipment | 🔍 Purpose |
|---|---|
| Vaccine Carrier | To transport stool/blood samples safely |
| Ice Packs (not frozen) | To keep temperature between 2–8°C |
| Temperature Monitor | Ensures cold chain was maintained |
| Sample Collection Kit | Sterile containers, labels, requisition form |
🔹 Collect 2 stool samples, 24–48 hours apart
🔹 Transport to lab within 72 hours
🔹 Maintain Reverse Cold Chain throughout
🔹 Use vaccine carrier with conditioned ice packs
🔹 Send with lab request form and label properly
✔️ Collect stool sample using sterile container
✔️ Label specimen with child’s ID, date/time of collection
✔️ Pack in reverse cold chain (2–8°C)
✔️ Transport sample to district/state surveillance unit
✔️ Do not delay → Reach lab within 72 hours
✔️ Record in AFP surveillance form
✅ Q1. Reverse cold chain is used for?
🅰️ Transporting biological specimens like stool for polio
✅ Q2. Ideal temperature for reverse cold chain is?
🅰️ +2°C to +8°C
✅ Q3. Stool samples for AFP should reach lab within?
🅰️ 72 hours
✅ Q4. How many stool samples are collected in AFP?
🅰️ 2 samples, 24–48 hours apart
✅ Q5. What equipment is used in reverse cold chain?
🅰️ Vaccine carrier with ice packs