SCENARIO: It is Monday morning, the 2nd of October 2017 and Sister Lisbeth, the sister in charge of a rural clinic in the Sunshine Province, returns back to work after four months’ maternity leave. While she was on maternity leave, her duties were taken over by Mary, a temporary nurse from an employment agency. When she arrives at the clinic, she is pleasantly surprised, as the nursing post that has been vacant at the clinic for more than two years has been filled! Although the new nurse, Gillian, has not had a lot of vaccination experience, Sister Lisbeth is so grateful to have an extra pair of hands in the clinic, and decides to immediately start with in-service training. The first client for the day is a young man who fell off his motorbike this morning, on his way to work. He has grazes along both arms and his knees are bleeding. Gillian goes to the refrigerator to get a tetanus-containing vaccine and returns with the news that the multi-dose tetanus vial was stuck to the wall of the refrigerator. Sister Lisbeth uses this as her first training opportunity and asks Gillian what she knows about the shake test.
QUESTION: The following statement/s made by Gillian is/are TRUE:
A.
The shake test is done to determine whether an aluminium-containing vaccine has been exposed to the higher temperatures that are found on the walls of the refrigerator.
B.
You take a vial of the same vaccine and batch and freeze it. You mark it and then, holding both vials in your hand, you vigorously shake the vials for 10-15 seconds and then allow to stand. After 5 minutes you compare them.
C.
After doing the test, you compare the vaccines to see how they settle. If the sediment settles rapidly and is still visible after the 5 minutes, the vaccine has not been frozen and is safe to use.
D.
If the vaccine appears to be smooth and cloudy and has no sediment after 5 minutes, it has been frozen and should not be used as the efficacy will be compromised.