During a vaccination session at a PHC, a health worker opens a vial of DPT vaccine. After the session ends with doses remaining, the nurse wants to know whether the vial can be used in the next session. According to India's Multi-Dose Open Vial Policy (MDOVP), which criterion MOST immediately determines whether this vial is usable?

• A Whether the vaccine was reconstituted or is a liquid vaccine that does not require reconstitution ✓
• B Whether the session was held at a cold chain point or outreach site
• C Whether more than 50% of doses remain in the vial
• D Whether the vial label shows a multi-dose presentation

Explanation

India's MDOVP distinguishes between vaccines that require reconstitution (lyophilised: BCG, measles, MR, JE live attenuated, varicella) and liquid multi-dose vaccines (DPT, TT, Td, OPV, HepB, IPV). Reconstituted vaccines MUST be discarded after the session (within 4 hours or end of session, whichever is earlier) because reconstitution introduces contamination risk. Liquid vaccines like DPT can be retained and used in subsequent sessions for up to 4 weeks provided VVM has not changed, cold chain was maintained, sterile needles were used, and expiry has not passed. The session venue (option B) is relevant only for reconstituted vaccines; for liquid vaccines, the above conditions apply at both fixed and outreach sites.

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.