A health worker at a sub-centre opens a vial of oral poliovirus vaccine (OPV) and uses it for 4 children during a session. The remaining doses are to be used at the next session 3 days later. The vial monitor (VVM) is still in Stage 1. Under the open vial policy, the correct course of action is:

• A Discard the vial as OPV must not be stored once opened beyond 4 hours
• B Store the opened vial at 2–8°C and use within 4 weeks if VVM has not changed and cap is intact
• C Store the opened vial and use within 28 days provided VVM is still in usable stage ✓
• D Transfer to a freezer at −15°C to −25°C to extend usability

Explanation

Under India's NIS open vial policy (2016, updated guidelines), OPV opened vials may be retained and used at subsequent sessions for up to 28 days provided: the VVM has not reached discard point, the vial is stored at appropriate temperature (2–8°C for OPV), no contamination has occurred, and the expiry date has not passed. This policy applies to multi-dose vials of OPV, measles, Hep B, and TT. Injectable vaccines like BCG and reconstituted vaccines (measles-rubella lyophilised) must be discarded within 4 hours.

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

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Written and medically reviewed by the StethoPrep medical team.