Design and Testing of a Thermoelectrically-Cooled Portable Vaccine Cooler

Elliot Reid, Jared Barkes, Cameron B. Morrison, A. Ung, Roshni Patel, Chase Rebarker, Parth Panchal, S. Vasa
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引用次数: 7

Abstract

and expiration --can be as high as 60-70% (Wallace, Willis, Nwaze, & Dieng, 2017; Zaffran et al., 2013). Although vaccine coolers are designed to keep vaccines cold, a poorly designed apparatus can result in accidental freezing of vaccines so that sub-potent vaccines can sometimes be administered (Chen, & Kristensen, 2009). A 2007 study found that in vaccine reports tracked longitudinally, 75-100% of vaccines were exposed to freezing temperatures; the authors recommend im-proved cold-chain transport equipment as a solution (Matthias, Robertson, Garrison, Newland, & Nelson, 2007). Vaccine freezing or overheating issues are not relegated solely to older studies or developing nations. The 2013-2014 H1N1pdm09 virus outbreak in the United States can likely be attributed to vaccine shipments being exposed to high temperatures (Caspard, Coelingh, Mallory, & Ambrose, 2016). The cost of most vaccines today ranges from $3.50-$7.50 per administration (Gates, 2012), so wastage results in a considerable economic loss. Importantly, when vaccines lose potency, there is a loss of confidence in vaccine therapy (Larson, Cooper, Eskola, Katz, & Ratzan, 2011). Thus, reducing vaccine wastage while in-creasing potency will provide more effective immunization in the rural, developing world at a reduced cost per dose. One way to address aspects of the wastage issue is the development of small coolers capable of transporting vaccines, maintained in the proper temperature range, from the regional health center to the distant client; this trip is termed the end stage of the cold chain. Coolers employing phase change materials including ice are capable of maintaining the desired temperature range for a period, but vaccines in such coolers are sometimes subject to overheating or freezing because of the lack of temperature regulation. INTRODUCTION Vaccines are a major economic cost and component of the worldwide battle against infectious disease. In 2011, UNICEF bought 2.5 billion doses of vaccines, and spent more than one billion dollars on vaccines (UNICEF, 2011). Within the category of develop-ment assistance for maternal and child health, donors spent $3.2 billion on child vaccines in 2014 (Dieleman, Murray, & Haaken-stad, 2015). Still, for children in developing countries, health care inequities are prominent, and access to preventative therapies and drugs is limited (Gates, 2012). One reason these countries lack enough vaccination coverage is due to insufficient cold storage (without freezing) in the vaccine supply chain (Humphreys, 2011). Breakdown of the vaccine cold chain is believed to be a major contributor to late 20th-century polio outbreaks in southern Africa (Schoub, & Cameron, 1996). Many vaccines must be maintained in a temperature range of 2-8°C to remain potent. Indeed, previous studies have shown that cold chain wastage--due to the failure to maintain vaccines in a safe temperature range, the need to discard unused portions of opened vaccine vials, and improper handling Design and Testing of a ThermoelectricallyCooled Portable Vaccine Cooler
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热电冷却便携式疫苗冷却器的设计与测试
和有效期——可以高达60-70%(Wallace,Willis,Nwaze,&Dieng,2017;Zaffran等人,2013)。尽管疫苗冷却器的设计是为了让疫苗保持低温,但设计不当的设备可能会导致疫苗意外冷冻,因此有时可以接种亚强效疫苗(Chen,&Kristensen,2009)。2007年的一项研究发现,在纵向追踪的疫苗报告中,75-100%的疫苗暴露在冰点下;作者推荐改进的冷链运输设备作为解决方案(Matthias,Robertson,Garrison,Newland,&Nelson,2007)。疫苗冻结或过热问题并不仅仅局限于较老的研究或发展中国家。2013-2014年美国爆发的H1N1pdm09病毒可能归因于疫苗运输暴露在高温下(Caspard,Coelingh,Mallory,&Ambrose,2016)。如今,大多数疫苗的成本在每届政府3.50美元至7.50美元之间(Gates,2012),因此浪费会造成相当大的经济损失。重要的是,当疫苗失去效力时,就会对疫苗治疗失去信心(Larson,Cooper,Eskola,Katz,&Ratzan,2011)。因此,在提高效力的同时减少疫苗浪费,将以降低每剂疫苗的成本,在发展中国家的农村地区提供更有效的免疫接种。解决浪费问题的一种方法是开发能够将疫苗从地区卫生中心运输到远程客户的小型冷却器,并保持在适当的温度范围内;这种跳闸被称为冷链的末端阶段。采用包括冰在内的相变材料的冷却器能够在一段时间内保持所需的温度范围,但由于缺乏温度调节,这种冷却器中的疫苗有时会过热或结冰。引言疫苗是全球抗击传染病的主要经济成本和组成部分。2011年,儿童基金会购买了25亿剂疫苗,并在疫苗上花费了超过10亿美元(儿童基金会,2011年)。在妇幼保健发展援助类别中,2014年,捐助者在儿童疫苗上花费了32亿美元(Dieleman、Murray和Haaken-stad,2015)。尽管如此,对于发展中国家的儿童来说,医疗保健不平等现象突出,获得预防性治疗和药物的机会有限(Gates,2012)。这些国家缺乏足够的疫苗接种覆盖率的一个原因是疫苗供应链中的冷藏(不冷冻)不足(Humphreys,2011)。疫苗冷链的崩溃被认为是20世纪末南部非洲脊髓灰质炎爆发的主要原因(Schoub,&Cameron,1996)。许多疫苗必须保持在2-8°C的温度范围内才能保持效力。事实上,之前的研究表明,冷链浪费——由于未能将疫苗保持在安全的温度范围内,需要丢弃打开的疫苗瓶的未使用部分,以及热电冷却便携式疫苗冷却器的设计和测试不当
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