Which of the following vaccines should not be kept in a freezer?

JODHPUR AIIMS SNO-2018

Pharmacology

Easy

Appeared in: JODHPUR AIIMS SNO-2018

Explanation

The Diphtheria, Pertussis, and Tetanus (DPT) vaccine is an inactivated, toxoid-based vaccine that is highly sensitive to freezing.
It contains an aluminum salt adjuvant, which is irreversibly damaged by freezing. This causes the components to clump together (agglutination).
This damage results in a significant loss of the vaccine's potency, rendering it ineffective.
Administering a previously frozen DPT vaccine can also increase the risk of local adverse reactions, such as painful sterile abscesses at the injection site.
The correct storage for DPT is in a refrigerator at a temperature range of +2°C to +8°C.

Option A: Oral Polio Vaccine (OPV) is a live attenuated vaccine and is highly sensitive to heat. To maintain its potency for long-term storage, it must be kept frozen, typically between -15°C and -25°C.
Option C: The Measles vaccine is a live attenuated vaccine, supplied in a freeze-dried (lyophilized) form. It is stored in the freezer to preserve its effectiveness until it is reconstituted for use.
Option D: The Measles, Mumps, and Rubella (MMR) vaccine is a combination live attenuated vaccine. Similar to the standalone measles vaccine, it is stored in a frozen state to ensure the viability and potency of its live viral components.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Vaccine storage and cold chain management as background academic context rather than a clinical decision trigger.
Proper vaccine storage is a critical nursing responsibility to ensure the effectiveness of immunization programs and prevent vaccine-preventable diseases.
Administering a damaged vaccine can lead to immunization failure, leaving the patient unprotected, and may cause local adverse reactions like sterile abscesses.
Nurses must be familiar with the 'Shake Test' to check if an adsorbed vaccine like DPT has been accidentally frozen. A damaged vial will show rapid sediment formation and must be discarded.

How to Approach the Question

First, identify the core of the question, which is to find the vaccine that is damaged by freezing.
Next, recall the two main categories of vaccines based on their composition: live attenuated and inactivated/toxoid vaccines.
Remember the general storage principle: live vaccines (like OPV, Measles, MMR) are typically stored frozen to protect them from heat, whereas inactivated vaccines containing adjuvants (like DPT) are sensitive to freezing.
Evaluate each option based on this principle. Polio (OPV), Measles, and MMR are all live vaccines.
DPT is an inactivated/toxoid vaccine known to be freeze-sensitive.
Therefore, select DPT as the vaccine that should not be kept in a freezer.

Concept Tested & Keywords

Concept Tested: Vaccine storage and cold chain management.
Stem keywords: vaccines, freezer, not be kept
Lead-in keywords: Which, not
Negative lead-in flag: Question asks which vaccine should NOT be kept in a freezer.

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E6 Ghai Essential Pediatrics(pp 26-904 of 913) pp. 214-216, 213-215

E6 Parks TextBook of Preventive & Social Medicine part 1 — Subpart A (pp 26-201 of 604) p. 103-105