From: bert <bert@schreud.uem.mz>
Producers of vaccines (Measles and BCG) claim, that the vaccine,
can only be diluted by the specific diluent delivered
with the same vaccine. Most of the time the diluent is simply
distilled water; some producers of measles use however saline; other
calim to use "special" apyrogenic water, whatever that may be.A universal diluent would have a number of advantages - like
interchangeability, fixed quantity and would take away the doubt,
health staff may sometimes have, what to do if the brand-
specific diluent is not available. This may not only lead to
unnecessarily throwing away of vaccines, but (even worse) provoking
adverse reactions by using powerful medicines or unsterile water,
which happened to be in the refrigerators (see WHO/UNICEF memorandum
to country offices - ref. VSQ/JBM/vc of 5.08.95).A universal diluent would have the additional advantage, of buying
it bulk and ship this by sea or produce it locally/regionally as
alternative for the expensive system of airfreigthing tons of
distilled water from one part of the world to the other.I would invite you all to contribute to (1) above in
general, on (2) whatever pharmacological argument could support the
claim of the vaccine producers to use only the brand specific diluent
and (3) whether WHO/UNICEF should use its efforts to require a
standard diluent.Looking forward receiving your reactions,
Bert Schreuder, Mozambique. Email: bert@schreud.uem.mz
Wilbert Bannenberg, public health consultant
CHD - Consultants for Health and Development
Brederodestraat 5, 1054 MP Amsterdam, The Netherlands
tel +31-20-6854659 fax +31-20-6891233 email wilbertb@xs4all.nl