Cold chain for vaccines – the key to success for vaccinations in Vietnam

Vietnam is facing the challenge of ensuring the highest standards of cold chain for vaccines during transportation to achieve the goal of expanding access to vaccines in the country, particularly in remote areas.

Mr. John Davison – CEO Zuellig Pharma

Vietnam has for years made great achievements in the implementation of the Vietnam Expanded Program on Immunization (EPI), initiated by the Ministry of Health (MoH) since 1981, making the country a highlight in the region with regards to the coverage of the programme nationwide. So far, the EPI has benefitted millions of women and children, with 95 per cent of children under one-year-old being vaccinated.

The MoH has now set the goal to improve the proportion of vaccination in areas that are at high risk of outbreaks, and in areas which are geographically difficult to reach, such as remote, mountainous or island areas. However, ensuring the highest standards of cold chain for vaccines has become a barrier to success of reaching the goal.

Vaccines have strict requirements in preservation during transportation. It is essential that vaccines are stored continuously at a temperature of between 2°C to 8°C. Any deviation or interruption in the cold chain from production, storage, transport and use can potentially damage the integrity of the vaccine, resulting in reduced efficacy and safety in treatment.

“To meet the goal of the EPI, we faced many challenges such as access to local health centres in remote areas, changes in temperature through different seasons and regions, and limited transport systems in remote areas. The importance of maintaining the cold chain to protect the prescribed temperatures during transport is crucial in helping to ensure the integrity and quality of pharmaceuticals as well as patient safety,” said Doan Huu Thien, director of the National Institute for Control of Vaccines and Biologicals (NICVB).

Evidently, provinces in remote, mountainous or island areas are still unable to ensure quality of the cold chain for vaccines. In these areas, the cold chain infrastructure for vaccines under the EPI funded by the government is being downgraded. In many communes, the majority of refrigerators have been in use since 2004 or 2005. In some districts, there is also no specific storage for vaccines.

Furthermore, employees of the Medical Prevention Departments in these areas are not trained in vaccine management and preservation.

For example, in the northern province of Son La, which is home to 204 communes, with 112 being underprivileged communes, Dr. Nguyen Tien Dung mentioned that it is difficult to ensure vaccination for all children especially those located in underprivileged and remote areas. As shown in the 2018 survey, about 464 out of a total of 3,323 villages in 101 communes do not have access to the EPI.

“Ensuring the quality of cold chain for vaccines is extremely important for vaccination. However, many refrigerators and other freezing facilities in the cold chain are currently spoilt and cannot be repaired,” said Dung. “Lack of staff for the CPI is another headache for the province.”

In light of this, NICVB, the National Institute of Hygiene and Epidemiology (NIHE) and Zuellig Pharma have officially announced a US$600,000 project to support the EPI in six northern provinces including Hai Duong, Bac Ninh, Quang Ninh, Ha Giang, Son La and Yen Bai through the use of the eZCooler – an innovative packaging technology that ensures the integrity of temperature sensitive products to the last mile of transportation.

Under the project to be carried out from 2018-2020, Zuellig Pharma - one of the largest healthcare services groups in Asia – will contribute eZCoolers in three capacities (8 litre, 12 litre and 96 litre) to these provinces, while cooperating with NICVB and NIHE to provide training to employees of their Medical Prevention Departments on international standards and Goods Storage Practices for cold chain supply management and usage of the eZCooler.

“We highly appreciate NICVB, NIHE and Zuellig Pharma in launching the project. The project management board should cooperate with NICVB and NIHE in assessing the effectiveness of the project so as to create a premise for the sustainable development of the cold chain supply chain in other localities in the future,” said Nguyen Minh Hang, deputy head of the MoH’s Preventive Medicine Department at the project launch. 

According to Business Monitor International, Vietnam’s healthcare expenditure was estimated at $16.1 billion in 2017, representing 7.5 per cent of its GDP and the figure will continue to grow at 12.5 per cent a year to $22.7 billion by 2021. Vaccines and cold chain products make up a significant part of this expenditure.

“Zuellig Pharma is honoured to contribute our innovative solutions to this project to ensure that everyone in the country has easy access to vaccines. We have been entrusted by companies around the world to undertake the supply of pharmaceuticals for nearly a hundred years in Asia and 19 years in Vietnam. Today, we are happy to be able to share our expertise and technology with the Vietnamese government and will work closely together with all parties to make healthcare more accessible in the country,” said Marc Franck – Chief Executive Zuellig Pharma Vietnam.

With this innovative technology, children and women in Son La and other provinces will most benefit from this, thus contributing to the success of the EPI.