Monitoring temperatures in the vaccine cold chain in Bolivia.

This study monitored vaccine cold chain temperatures during routine DTP-HB-Hib vaccine shipments from central stores to 11 communities in 3 provinces of Bolivia. In all 11 monitored shipments, vaccines were exposed to freezing temperatures at one or more points. In each of the shipments, temperatures below 0 degrees C were recorded for 2-50% of the monitoring period. Freezing occurred at almost every level of the cold chain distribution system, especially during district and health center storage and during transport to the province and district levels. Seven of the 11 shipments were exposed to temperatures above 8 degrees C, although none were exposed to excessive heat longer than 1.3% of the total monitoring period.