page_title: Cold chain
section_title: Uses
hierarchical_section_title: Cold chain / Uses
caption_attribution_description: English: Vaccine "cold chain". From the GiveWell visit to NGO Village Reach in Pemba, Mozambique and surrounding areas. February 2010. More information.
context_page_description: The term cold chain or cool chain denotes the series of actions and equipment applied to maintain a product within a specified low-temperature range from harvest/production to consumption. A cold chain is a temperature-controlled supply chain. An unbroken cold chain is an uninterrupted series of refrigerated production, storage and distribution activities, along with associated equipment and logistics, which maintain a desired low-temperature range. It is used to preserve and to extend and ensure the shelf life of products, such as fresh agricultural produce, seafood, frozen food, photographic film, chemicals, and pharmaceutical products. Such products, during transport and when in transient storage, are sometimes called cool cargo. Unlike other goods or merchandise, cold chain goods are perishable and always en route towards end use or destination, even when held temporarily in cold stores and hence commonly referred to as cargo during its entire logistics cycle.
  Cold chain logistics includes all of the means used to ensure a constant temperature for a product that is not heat stable, from the time it is manufactured until the time it is used.
context_section_description: Cold chains are common in the food and pharmaceutical industries and also in some chemical shipments. One common temperature range for a cold chain in pharmaceutical industries is 2 to 8 °C (36 to 46 °F), but the specific temperature (and time at temperature) tolerances depend on the actual product being shipped. Unique to fresh produce cargoes, the cold chain requires to additionally maintain product specific environment parameters which include air quality levels (carbon dioxide, oxygen, humidity and others), which makes this the most complicated cold chain to operate.
  This is important in the supply of vaccines to distant clinics in hot climates served by poorly developed transport networks.  Disruption of a cold chain due to war may produce consequences similar to the smallpox outbreaks in the Philippines during the Spanish–American War.
  There have been numerous events where vaccines have been shipped to third world countries with little to no cold chain infrastructure (Sub-Sahara Africa) where the vaccines were inactivated due to excess exposure to heat. Patients that thought they were being immunized, in reality were put at greater risk due to the inactivated vaccines they received.  Thus great attention is now being paid to the entire cold chain distribution process to ensure that simple diseases can eventually be eradicated from society.
  Traditionally all historical stability data developed for vaccines was based on the temperature range of 2–8 °C (36–46 °F). With recent development of biological products by former vaccine developers, biologics has fallen into the same category of storage at 2–8 °C (36–46 °F) due to the nature of the products and the lack of testing these products at wider storage conditions.
  The cold chain distribution process is an extension of the good manufacturing practice (GMP) environment that all drugs and biological products are required to adhere to, enforced by the various health regulatory bodies. As such, the distribution process must be validated to ensure that there is no negative impact to the safety, efficacy or quality of the drug substance. The GMP environment requires that all processes that might impact the safety, efficacy or quality of the drug substance must be validated, including storage and distribution of the drug substance.
caption: Cold chain being maintained using ice box while transporting polio vaccine
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