VACCINE ARRIVAL REPORT ( VAR ) 1

 

This report is to be filled in by authorized staff, ratified by the Store Manager or the EPI Manager, and forwarded to the procurement agency within three days of vaccine arrival. Use one report for each vaccine in the shipment.

 

 

COUNTRY

 

 

 

 

REPORT No.

 

 

Date of report

 

 

Place, date and time of inspection

Name of cold store, date and time vaccines entered into cold store

 

 

 

PART I — ADVANCE NOTICE

 

MAIN DOCUMENTS

Date received by consignee

Copy airway bill (AWB)

Copy of packing list

Copy of invoice

Copy of release certificate

Pre-advice

 

 

 

 

 

 

 

 

 

Shipping notification

 

Yes          No 

Yes            No 

Yes          No 

Yes          No 

 

List other documents (if requested)

 

 

PART II — FLIGHT ARRIVAL DETAILS

 

AWB Number

Airport of destination

Flight No

ETA as per notification

Actual time of arrival

Date

Time

Date

Time

 

 

 

 

 

 

 

 

NAME OF CLEARING AGENT: _____________________________    ON BEHALF OF: _______________________________

 

PART III — DETAILS OF VACCINE SHIPMENT

 

Purchase Order No.

Consignee

Vaccine description

(Type and doses/vial)

Manufacturer

Country

 

 

 

 

 

 

Vaccine

Diluent/droppers

Lot Number

Number of boxes

Number of vials

Expiry date

Lot Number

Number of boxes

Number of units

Expiry date

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(Continue on separate sheet if necessary)

 

 

Yes

No

Comments

Was quantity received as per shipping notification?

 

 

 

If not, were details of short-shipment provided prior to vaccine arrival?

 

 

 

 


1 Adopted from the Standard UNICEF Vaccine Arrival Report from WHO Guidelines on the international packaging and shipping of vaccines (WHO/IVB/05.23)

No. = Number

WHO recommends all UN agencies, countries and non-governmental organizations procuring vaccines adopt this report.

Report No.

 

 

PART IV — DOCUMENTS ACCOMPANYING THE SHIPMENT

 

Invoice

Packing list

Release certificate

Vaccine Arrival Report

Other

    Yes         No

   Yes         No

   Yes         No

     Yes         No

 

Comments

 

 

 

PART V — STATUS OF SHIPPING INDICATORS

 

Total number of boxes inspected:

 

 

Coolant type:

Dry ice                          Icepacks                                No coolant 

Temperature monitors present: 

    VVM                   Cold-chain card                       Electronic device                       Type: _______________

 

 

PROVIDE BELOW DETAILS OF STATUS ONLY WHEN PROBLEMS ARE OBSERVED

(in addition fill in ALARM REPORTING FORM if there are any ALARMS in electronic devices):

 

Box Number

LOT NO

Alarm in electronic device

Cold-chain monitor

Date/time of inspection

>=45 0 C

>=30 0 C

>=10 0 C

<=-0.5 0 C

A

B

C

D

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(Continue on separate sheet if necessary)

 

PART VI — GENERAL CONDITIONS OF SHIPMENT

 

What was the condition of boxes on arrival?

 

Were necessary labels attached to shipping boxes?

 

Other comments including description of  alarms in electronic devices:

(continue on separate sheet if necessary).

 

 

 

 

 

 

 

 

 

 

 

PART VII — NAME AND SIGNATURE

 

Authorized Inspection Supervisor DATE Central store or EPI Manager                             DATE

 

For Procurement Agency office use only

 

Date received by the office:  ______________________________        Contact person: _______________________________

Guidelines for completing the Vaccine Arrival Report

 

The Vaccine Arrival Report (VAR) is a comprehensive record of cold-chain conditions during transport and of required compliance with shipping instructions. Recipient governments and procurement agencies (UNICEF country offices, UNICEF Supply Division, PAHO Revolving Fund), are responsible for the report, and for taking appropriate action if problems are reported (e.g. follow-up with the manufacturer, forwarding agent, WHO, etc.).

Use one report form for each shipment and for each vaccine in the shipment. In shipments containing diphtheria–tetanus–pertussis (DTP)–Hepatitis B (HepB) and Haemophilus influenzae type b (Hib) vaccines, use one form for DTP–HepB and a separate form for Hib. In the case of short-shipments (where parts of the original quantities are not delivered), complete a separate report for each part delivered.

Complete the form as described below. In the header boxes at the top of the form, enter the name of the recipient country, the report number, and details of place and date of inspection and storage. The report number is an internal number for organizing records; compile it as follows: country code; year; number for each report (e.g. BUR–2005–001 for one vaccine; BUR–2005–002 for a second vaccine, etc.). In the case of a short-shipment, the numbers for the separate deliveries would be, for example, BUR–2005–003.1, BUR-2005-003.2, etc.

 


Part I — Advance notice

I.1 Enter dates and details of documents received in advance of the vaccine shipment.

Part II — Flight arrival details

II.1 Fill in details of expected and actual arrival times for the shipment.

II.2 Fill in the name a) of the clearing agent and b) for whom the agent acts (e.g. the Ministry of Health, UNICEF or WHO).

Part III — Details of vaccine shipment

III.1 Fill in details of the order (purchase order number, consignee, vaccine description etc.).

III.2 For each batch of vaccine included in the shipment, record:

a) the number of shipping boxes;

b) the number of vials;

c) the expiry date.

The number of boxes you enter should always match the number of boxes shown in the packing list. If it does not, note under Comments if advance notice of a change in the quantity was provided. It is not necessary to count the number of individual vaccine packs in each shipping box for this report.

III.3 For the diluents and droppers (if included) with each batch of vaccine in the shipment, record:

a) the number of shipping boxes;

b) the number of vials;

c) the expiry date.

The information for III.2 and III.3 is also in the packing list.

Note : Diluents for freeze-dried vaccine and droppers for oral polio vaccine (OPV) are integral parts of the vaccine, so always include them on the same form. If diluent/droppers are delivered separately, consider it a short-shipment.

Part IV — Documents accompanying shipment

The packing list should indicate which box contains the shipping documents (usually Box 1).

IV.1 If this information is not included in the packing list or in documents sent separately by courier, pouch or other means, note this under Comments .

IV.2 Verify that all necessary documents are present and complete the form accordingly.

Note: If the lot release certificate is missing, do not use the vaccines; keep them on hold in cold storage until the relevant document has been obtained from the vaccine manufacturer.

PART V — Status of shipping indicators

Inspect the temperature monitors in all boxes before putting vaccines into cold storage. For very large shipments, or when immediate storage in the shipping boxes is required, check a representative number of boxes before placing the shipment in the cold store. Complete inspection of all boxes the next day, or as soon as possible thereafter; under Comments , note the date and time when the complete inspection took place.

Note: In this report, enter the information below (V.1) only for boxes in which the temperature monitor shows a change that indicates potential damage to vaccines (alarm indication in the electronic device, or cold-chain monitor card as per vaccine/threshold table in card).

V.1 Enter:

a) the number of boxes inspected (this should equal the total number in the shipment);

b) the type of coolant used;

c) details of any temperature exposure detected.

V.2 Photocopy or scan LCD screens in electronic devices that show alarm status and attach to the report.

V.3 Clearly identify vaccines in boxes in which the indicator shows exposure to temperatures that risk damage and keep them in the cold room for further assessment of their condition. Do not discard vaccines until assessment is completed.

PART VI — General conditions of shipment

VI.1 Indicate if the shipping boxes were received in good condition and if all necessary labels on the outside of the shipping boxes were present; add any comments.

PART VII — Name and signature

VII.1 The authorized person responsible for the inspection and the Central Store Manager or the EPI Manager should sign this report.

VII.2 Send the form, completed and signed, to the procuring agency (UNICEF country office, Ministry of Health, or WHO country office) within three days of arrival of the vaccine.



Reporting ALARM details in international vaccine shipments

 

A special form has been designed for the purpose of reporting alarm details displayed in electronic devices. This form should ONLY be filled in if any alarms have occurred, and should be attached to the Vaccine Arrival Report (VAR). A clear photocopy and/or printed copy of the scanned image of the electronic devices displaying alarm status should be attached to this form.

 

ELECTRONIC DEVICE ALARM REPORT FORM

 

Country

 

Date of report

 

 

 

 

 

Type of device

 

Q-tag 2 plus

Spytemp II OMS

3M TX01/02

 

Type of vaccine

 

 

 

 

 

Box no

Serial number

Time stopped

Elapsed transit time

>=45 0 C 1 hour

>=30 0 C 10 hrs

>=10 0 C 20 hrs

<=-0.5 0 C 1 hr

Time

o C

Time

o C

Time

o C

Time

o C

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Use additional pages if necessary.

 

Guidelines for completing the Electronic Device Alarm Report Form

 

Country

Enter name of the country.

Date of report

Enter date of report.

Type of device

Mark the type of device by ticking the appropriate box.

Type of vaccine

Enter the type of vaccine, e.g. BCG, OPV, measles or DTP-HepB.

Box number

Write the number of the box (carton) that the electronic device was taken out of, e.g. 001, 002, … 099.

Serial number

Write down the serial number of the electronic device from the bar code/serial number, e.g. 10000001 for Q-tag 2 plus, S1-OMS1/ 1860 for Spytemp II OMS, and TX01-0000149 for 3M TX01/02. Note that the serial numbers of the devices can be found on the front surfaces of the Q-tag 2 plus and 3M TX01/02 devices, and on the reverse of the Spytemp II OMS attached to the backing card.

Time stopped

Enter the local time you stopped this particular device in 00hrs:00min format.

Elapsed transit time

Enter elapsed transit time.

Time

Enter time displayed in HISTORY mode for each alarm. For the Q-tag 2 plus and Spytemp II OMS devices, the trigger time of the alarm is displayed as 000 hrs. 00 mins., e.g. 62:40 or 067:32. In 3M TX01/02 devices the day is separately displayed as 00 and time is given only in 00 hrs. and 00 mins. For all 3M devices enter the time as 00(day):00(hr.):00(min.), e.g. 01:12:15 would mean that the alarm was triggered 1 day 12 hours and 15 minutes following activation.

o C

Enter minimum or maximum temperatures displayed for each alarm, e.g. 34.7 o C, 13.5 o C, or -4.5 o C.

If any of the alarms are repeated in the same electronic device, enter this information in a new row.

SIMULATION

 

You have received a DTP-HepB shipment accompanied by electronic devices. In box Number 5 the device displayed ALARM status. Different alarm situations will be given in the following pages with explanations on how to carry this information on to the reporting form.

 

 

 

 






 

 

 

 

 

 

 

 

 

 

 








 

 

 

 

 

 

 

 

 





 

 

 

 

 

 

 

 

Example of completed reporting form with repeating alarms in the same device