VVM guidelines

5.4.6 How to check for heat damage?

Vaccine Vial Monitor (VVM)

Reading VVM: VVMs are labels on vaccine vial that have a small white square inside a blue circle. As the vial is exposed to cumulative high temperature, the color of the white square will change. Read the VVM (see below) and determine whether the vaccines have been damaged by heat. If these vaccine vials show change in colour to the discard point, then discard the vaccines. Remove vaccines that have reached discard point from the vaccine carrier.

Vaccine Vial Monitor and reaction rates:

There are four types of VVM, which are assigned based on the different stability characteristic of the product.

The table below summarizes different levels of VVM reaction rates by category of heat stability

Category (vaccines)	No. of days  to end point at +37C	No. of days to end point at + 25 C	Time to end point at +5C
VVM 30: High stability	30	193	Ø  4 years
VVM 14: Medium stability	14	90	>3 years
VVM7: Moderate rate stability	7	45	Ø  2 years
VVM 2: Least stable	2	NA	225 days