From production to injection: the road to a vaccine
Let’s look at the journey a single dose of a vaccine makes to get to you.
- Available in:
- Հայերեն
- English
Little Katrin has just turned seven weeks old and is at Surb Grigor Lusavorich medical center with her mum to receive her routine vaccines. Before entering the immunization room, Katrin’s pediatrician examines her, measures her temperature, and only then consider her ready to get vaccinated.
Have you ever wondered about the process vaccines undergo before they are injected into our bodies? We were curious, so we recently spoke with some experts to find out more.
In 2021, Liqvor Pharmaceuticals started the production of a COVID-19 vaccine to support the fight against the spread of the virus across the country and the region. With the production of this vaccine, Armenia earned its place among vaccine producing countries. To better understand the production process, we spoke with Liqvor's Director Sergey Matevosyan.
“Vaccine production is a highly specialized process with unique requirements and technology. Armenia receives the raw materials for the vaccine from Russia. The main raw material, the substrate, is first processed, then undergoes primary and secondary packaging, and is continuously stored in a limited temperature range,” Matevosyan explains.
The vaccine substrate arrives in Armenia through a cold chain system with a storage temperature of -18ºС. Once in Armenia, the company's specialists analyze the substrate with 14 inspection points.
“When we're sure that everything meets the standards, the substrate goes off to technological processing, that is, vaccine production to its final form. We carry out the production process very quickly so that the temperature does not rise. The vaccine is a biological product [and must be stored at a certain temperature]. After it is processed, it quickly goes to primary packaging and immediately to the refrigerator. Another 14 types of analyses are then carried out. When we are sure everything is normal, we move on to final packaging,” says Matevosyan.
The vaccines are later placed in boxes, which are put in special containers in refrigerated trucks and transported to the National Center for Disease Control and Prevention (NCDC).
“The containers are accompanied by data loggers, special devices that record the temperature in that particular container during transportation,” noted the director.
Later, an NCDC specialist checks the device to ensure that the necessary temperature conditions are maintained. If the temperature exceeds the permissible level by even one degree at any stage of the journey, the specialist may not accept the vaccine. If all transportation conditions are met, the manufacturer's responsibilities are done.
Vaccines intended for routine immunization are imported to Armenia mainly from Europe: France, England, Denmark, and Belgium. The Bulgarian-made BCG vaccine is imported from Canada.
All vaccines entering Armenia are stored at NCDC's national vaccine warehouse. Every month, the NCDC distributes necessary vaccines to medical institutions in Yerevan and once a quarter to the regions of Armenia. In the regions, vaccines are stored in freezers and refrigerators at NCDC regional branches. From there, they are distributed to primary healthcare institutions every month.
“Be it COVID-19 vaccines, or flu or children's routine immunization vaccines, upon arrival in Armenia, all vaccines are transported from the airport to the NCDC national warehouse in refrigerated trucks. The vaccines are then stored in the center's cold rooms,” Almast Haroyan, the head of the Medical Immunobiological Vaccines Department of the NCDC explains.
Vaccines are stored in numbered cold rooms, two of which are 40 cubic meters, while the other four are 10 cubic meters.
“I can monitor the temperature of the refrigerators of any Yerevan polyclinic with a special application. The fresh Tag device shows the highest and lowest temperature recorded in the refrigerator throughout the day. It also stores the data for sixty days,” Haroyan explains.
The small vials of all vaccines other than the COVID-19 vaccine have thermal indicators - sensors that start to turn black in case the thermal regulations are violated.
Different vaccines require different storage temperatures. Viral vector vaccines are stored at a temperature of +2ºС to +8 ºС, while mRNA vaccines are stored at cooler temperatures: -80ºС to -20ºС. At those temperatures, mRNA vaccines can be stored for up to six months, but in the polyclinics, they have the right to be held for up to 30 days at the standard +2ºС to + 8ºС temperature,” Haroyan says.
The differences in COVID-19 vaccines
Vaccines are transported from Yerevan's national warehouse of vaccines to medical institutions in refrigerated trucks. Recently, a third refrigerated truck was added to the two, which serve the regions.
In polyclinics, vaccines are stored in special refrigerators for vaccines at +2ºС to +8 ºС. This year, the NCDC supplied 280 freezers and 85 refrigerators provided by UNICEF with the financial support of the United States Agency for International Development (USAID) to 250 primary healthcare institutions in Yerevan and the regions.
“In polyclinics vaccines are stored in refrigerators and freezers and monitored through the fresh tag. The fresh tag warns us in case of a slight temperature change in a refrigerator or freezer. Currently the fresh tag shows that it is 4ºС in the refrigerator, and during the day the highest recorded temperature was 7ºС, the lowest - 3ºС. Which means that the required temperature range of 2ºС to 8ºС was maintained. We check the device every day: in the morning and the evening, and fill in the data in special blanks,” explains Zhanna Gevorgyan, children's immunization nurse at the Surb Grigor Lusavorich polyclinic.
Prioritizing on her daughter's health and following her pediatrician's advice, Katrin's mum knew from the start that she would follow the national routine immunization plan and vaccinate her child, giving her the best possible protection. That day, Katrin received the second dose of the pentavalent vaccine, which protects against hepatitis B, pertussis, diphtheria, and the Hemophilus type B infection.
Nurse Gevorgyan notes that when children come to be vaccinated, they first check whether the child's age corresponds to the schedule of routine immunization plan and if the vaccination was correctly prescribed. After vaccination, they register the data in the national ArmEd system and then schedule the child's next vaccination. “Before turning into an adult, children are normally expected to receive 15 nominal vaccinations in Armenia,” Gevorgyan explains.
National Scheduled Immunization Calendar.
Maintaining public health is one of the most essential and strategic processes for Armenia. Infectious diseases that can be prevented through vaccinations are a main reason for morbidity. Children under the age of five belong to the most vulnerable group. For this reason, the BCG vaccination is given within 0-48 hours of being born, before the child has contact with other children. This vaccine protects from severe forms of tuberculosis. Normally, two to three weeks after vaccination, a small pus blister will emerge at the injection site; later a scar will form.
“Thanks to vaccinations, a child is fully protected from a number of infections that can have unwanted complications and consequences if contracted, including death or disability,” says Gevorgyan.
After injection, our body starts its work to develop immunity against the virus, developing full protection in the next four weeks. But that’s another story!
