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Preventing ‘flu when we flew
Flu vaccination in Laos

Flying pretty much anywhere these days is expensive. And it’s almost twice as expensive when I travel with my daughter.

And the reason is simple: The route from airport security to the departure gate is littered with opportunities to spend money. There are stores that sell expensive clothes, jewelry, electronics, duty-free goods, food and tacky tee-shirts that announce to the world that the wearer has spent time in the City of Atlanta. (The “I’m a Georgia Peach” key ring complements the tee shirt nicely, by the way.)

Traveling to see family in China once, my daughter and I had too much time to kill in the airport. And, like a wasp to blueberry jelly, she was immediately drawn to the most expensive items for sale in the retail area.

She couldn’t contemplate such a long journey without the latest iPad, she explained to me. She’d never be able to sleep on the aircraft unless she tired herself out with the latest hand-held game console, she advised. And there was no possibility of looking chic in China unless she purchased (meaning, unless I purchased) a couple of new outfits. Oh, and incidentally, expensive UGG boots are “in” this year.

One hand tightly gripping my wallet, I used the other hand to steer her away from purchases that I’d need a second mortgage for, and propelled her instead to a flu shot station. Our trip would be short, and I didn’t want either of us to spend four or five days in bed feeling like death warmed over. Flu, as I discovered several years ago is no fun at all, so a convenient flu shot at the airport seemed like a quick and convenient preventative.

At the flu shot location, I asked a few questions before releasing my grip on my wallet and rolling up my sleeve. Flu vaccine, you see, is temperature-sensitive and needs to be kept at between two and eight degrees Celsius. Outside that temperature range, the vaccine quickly loses its potency. And one of the challenges is that there’s no way of telling visually that the vaccine has been compromised by heat or cold. You’d need the facilities of an advanced lab for that—something that you’re unlikely to find even at the world’s busiest airport.

So I was keen to know about the logistics behind these flu vaccines. It was easy to see that they were kept in a fridge at the airport facility, but what was the story before they arrived? The answer I got was reassuring; none of the frequent errors in temperature-sensitive shipping appear to have been made. Here are a few.

  1. The packaging is insufficiently insulated to maintain the correct internal temperature for the duration of its journey from manufacturer to the point of care.
  2. The material used to maintain temperature on the journey (for example, gel packs) have been conditioned by freezing them to minus twenty degrees Celsius, and the frozen material comes into too-close proximity to the vaccines.
  3. The package itself is exposed to temperature extremes. It’s important to plan for ambient temperatures. Atlanta in winter may present no problems, and the same would go for Chicago in summer. But reverse the seasons in each location and you’re up against extremes.  In the case of flu vaccines, therefore, which typically begin to be administered in September, the challenge as the winter progresses will be Chicago’s temperature extremes.

In our case, the administering nurse explained to me that flu shots arrived in packages with temperature indicators. These are small paper cards with chemicals embedded that will change color if the package has been in conditions that are beyond the desired range. For manufacturers, the use of these is definitely worth it: for about a buck, you can show that their products are in optimal condition on arrival. And so, content with the explanation we were given, my daughter and I each rolled up a sleeve, looked away from the needle and were very brave.

If you choose to have a flu shot this winter, I recommend you ask the person administering the shot a couple of questions before you grin and bear it.

  1. In what kind of packaging did the shots arrive at the point of care?
  2. Where was it shipped from and how long was the time in transit?
  3. Was the vaccine in direct contact with frozen gels? (This is crucial: Frozen gel packs help reduce the inside temperature of the package. They also create, however, a risk of coming into direct contact with the vaccine and destroying its potency.).
  4. How is the vaccine stored at the point of administration?

If the answer to any of these questions concerns you then you might derive greater peace of mind by getting your shot from an alternative source. Remember: The supply chain is only as strong as its weakest link.

“I’ve been extremely brave,” my daughter announced as a Band-Aid was applied to her upper arm. “I totally deserve a reward.” And off she ran to press her nose against yet another store window, her eyes wide and her mind full of expensive possibilities…

Category: Healthcare
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