At a session site, a vial of measles-containing vaccine is reconstituted with diluent at 9 am. Under the open vial policy and standard UIP rules, what must be done with this vial?

• A It may be used until the end of the session the same day if kept at 2 to 8 degrees Celsius
• B It must be discarded within 4 hours of reconstitution, irrespective of the number of doses used ✓
• C It may be used for up to 4 hours after opening, since it contains thiomersal preservative
• D It may be stored overnight at 2 to 8 degrees Celsius and used the next morning

Explanation

Reconstituted freeze-dried vaccines such as measles, BCG and JE contain no preservative and carry a serious risk of contamination and loss of potency, so WHO and UIP rules require discarding them within 4 hours of reconstitution or at the end of the session, whichever is earlier. The open vial policy permitting reuse up to 4 weeks applies only to certain liquid vaccines with preservatives such as OPV, DTP, TT, Td and hepatitis C, never to reconstituted lyophilised vaccines.

Reference: Park's Textbook of Preventive and Social Medicine, 27th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.