Temperature Sensitivity of Vaccines

March 2014
 Temperature sensitivity of vaccines
Varicella-
zoster virus
OPV Influenza
Heat sensitivity JE
inactivated IPV
Most sensitive live
Rotavirus
MMR Rotavirus DTaP Hexa-
Measles Cholera
inactivated valent
Rubella Yellow Penta-
fever DTwP valent
Vaccine formulation
BCG Pneumo
PS-PCV Freeze dried
Vaccines to the
JE
inactivated left of the line
are not damaged HPV Liquid, no adjuvant
Hib by freezing MenC
PS-PCV Liquid, with alum
Hib adjuvant
MenA T, DT, dT
PS-PCV*
Typhoid
Least sensitive Rabies PS HepA HepB

Freeze sensitivity *The diluent for MenA PS-PCV

contains alum adjuvant and is
Not Least Most
freeze sensitive.
sensitive sensitive sensitive
 Vaccine sensitivity to heat
Heat sensitivity Vaccine
Most sensitive Oral poliovirus
Varicella-zoster virus
Influenza (inactivated, split)

Inactivated poliovirus
Japanese encephalitis (live)
Measles, mumps, rubella  Use vaccine vial
Cholera (inactivated) monitors to
DTaP
DTwP monitor heat
DTaP-hepatitis B-Hib-IPV (hexavalent)
DTwP-hepatitis B-Hib (pentavalent)
exposure.
Hib (liquid)
Measles
Rotavirus (liquid and freeze dried)
Rubella
Yellow fever All freeze-dried vaccines
Bacillus Calmette-Guérin become much more heat
Human papillomavirus sensitive after they are
Japanese encephalitis (inactivated) reconstituted.
T, DT, dT

Least sensitive Hepatitis A

Hepatitis B
Hib (freeze dried)
Meningitis A (polysaccharide-protein conjugate)
Meningitis C (polysaccharide-protein conjugate) Note: Bolded vaccines are freeze
Pneumococcal (polysaccharide-protein conjugate) dried.
Rabies
Typhoid PS
 Vaccine sensitivity to freezing
Freeze sensitivity Vaccine
Most sensitive DTaP
DTaP-hepatitis B-Hib-IPV (hexavalent)
DTwP
DTwP-hepatitis B-Hib (pentavalent)
Hepatitis A
Hepatitis B
Human papillomavirus
Meningitis C (polysaccharide-protein conjugate)
Cautions:
 Never expose these
Pneumococcal (polysaccharide-protein conjugate)
vaccines to zero or subzero
T, DT, dT
temperatures.
Cholera (inactivated)  Avoid the use of ice for
Influenza (inactivated, split) transport.
Hib (liquid)
Inactivated poliovirus
Least sensitive
Typhoid PS
Rotavirus (liquid)*

These vaccines are not Meningitis A (polysaccharide-protein conjugate)† * While the stability data for liquid
damaged by freezing. Yellow fever rotavirus vaccines demonstrate some
resistance to freezing, the
Bacillus Calmette-Guérin
temperature handling
Hib (freeze dried) recommendations in the vaccine
Japanese encephalitis (live and inactivated) product insert should be followed.
Measles † The diluent for MenA PS-PCV
Measles, mumps, rubella contains alum adjuvant and is freeze-
Oral poliovirus sensitive.
Rabies
Note: Bolded vaccines are freeze
Rotavirus dried.
Rubella
Varicella-zoster virus
Abbreviations
BCG: bacillus Calmette-Guérin IPV: inactivated poliovirus vaccine
DTaP: diphtheria, tetanus, acellular pertussis JE: Japanese encephalitis
DTwP diphtheria, tetanus, whole-cell pertussis Men A: meningitis A
HepA: hepatitis A Men C: meningitis C
HepB: hepatitis B MMR: measles, mumps, rubella
Hexavalent DTaP-hepatitis B-Hib-IPV OPV: oral polio vaccine
Hib: Haemophilus influenzae type b Pentavalent DTwP-hepatitis B-Hib
HPV: human papillomavirus Pneumo: pneumococcal
Influenza: influenza (inactivated, split vaccine) PS: polysaccharide
PS-PCV: PS-protein conjugate vaccine

T, DT, dT: tetanus, diphtheria tetanus, diphtheria

(low-dose) tetanus
Information sources
1. PATH, Working in Tandem. Summary of Vaccine Stability Data. Seattle: PATH; 2012. Available at:
http://www.path.org/publications/detail.php?i=1696.
2. World Health Organization. Temperature Sensitivity of Vaccines. Geneva: WHO; 2006. Available at:
http://www.path.org/vaccineresources/files/Temp_sensitivity_WHO.pdf.

Acknowledgments
These slides have been adapted from an original slide set produced by Julie Milstien and John Lloyd at the
Technet 2006 consultation.
Extra slides for adaptation
 Temperature sensitivity of vaccines
Varicella-
zoster virus
OPV Influenza
Heat sensitivity JE inactivated
IPV
Most sensitive live Rotavirus
MMR Rotavirus DTaP Hexa-
Measles Cholera
inactivated valent
Rubella Yellow Penta-
fever DTwP valent

BCG Pneumo
PS-PCV
JE
Vaccines to the Vaccine formulation
inactivated left of the line
are not damaged HPV Freeze dried
Hib by freezing MenC
PS-PCV Liquid, no adjuvant
Hib
MenA T, DT, dT
PS-PCV* Liquid, with alum
Typhoid adjuvant
Least sensitive Rabies PS HepA HepB

Freeze sensitivity *The diluent for MenA PS-PCV

contains alum adjuvant and is
Not Least Most
freeze sensitive.
sensitive sensitive sensitive
 Temperature sensitivity of vaccines
“Traditional”
Heat sensitivity OPV
EPI vaccines
Most sensitive
MMR
Measles
Rubella Penta-
DTwP valent

BCG
Vaccines to the Vaccine formulation
left of the line
are not damaged Freeze dried
Hib
by freezing
Liquid, no adjuvant
Hib
T, DT, dT Liquid, with alum
Least sensitive adjuvant
HepB

Freeze sensitivity
Not Least Most
sensitive sensitive sensitive
 Temperature sensitivity of vaccines
OPV “Traditional” EPI
Heat sensitivity
Most sensitive Rotavirus
and newer vaccines
MMR Rotavirus
Measles
Rubella Penta-
DTwP valent

BCG Pneumo
PS-PCV
Vaccines to the Vaccine formulation
left of the line
are not damaged HPV Freeze dried
Hib
by freezing
Liquid, no adjuvant
Hib
T, DT, dT Liquid, with alum
Least sensitive adjuvant
HepB

Freeze sensitivity
Not Least Most
sensitive sensitive sensitive
 Temperature sensitivity of vaccines
OPV
“Traditional” EPI and
Heat sensitivity regionally specific vaccines
JE
Most sensitive live
MMR Cholera
Measles
inactivated
Rubella Yellow Penta-
fever DTwP valent

BCG
JE Vaccines to the Vaccine formulation
inactivated left of the line
Hib are not damaged Freeze dried
by freezing
Liquid, no adjuvant
Hib
MenA T, DT, dT
PS-PCV* Liquid, with alum
Typhoid adjuvant
Least sensitive Rabies HepB
PS

Freeze sensitivity *The diluent for MenA PS-PCV

contains alum adjuvant and is
Not Least Most
freeze sensitive.
sensitive sensitive sensitive
 Temperature sensitivity of vaccines
Varicella-
“Traditional” EPI,
zoster virus
OPV Influenza
newer and middle-/
Heat sensitivity
Rotavirus
inactivated IPV upper-income
Most sensitive
MMR Rotavirus DTaP Hexa-
country vaccines
Measles
valent
Rubella Penta-
DTwP valent

BCG Pneumo
PS-PCV
Vaccines to the Vaccine formulation
left of the line
HPV Freeze dried
Hib are not damaged
MenC
by freezing PS-PCV Liquid, no adjuvant
Hib
T, DT, dT Liquid, with alum
Least sensitive adjuvant
HepA HepB

Freeze sensitivity
Not Least Most
sensitive sensitive sensitive
 Temperature sensitivity of vaccines
Varicella-
zoster virus
Influenza
Middle-/upper-
Heat sensitivity
inactivated
IPV income country
Most sensitive
DTaP Hexa- vaccines
valent

Vaccines to the Vaccine formulation

left of the line
are not damaged Freeze dried
MenC
by freezing PS-PCV Liquid, no adjuvant

Liquid, with alum

Least sensitive adjuvant
HepA

Freeze sensitivity
Not Least Most
sensitive sensitive sensitive