The first South African Cold Chain Manual was the first comprehensive guideline for the management of vaccines and related substances in South Africa. This manual is the third edition and is a guideline for managing vaccines and their associated products at all levels of health care service. Each healthcare worker handling and or managing vaccines should own a Cold Chain Manual and use it as a reference to the handling and management of vaccines and related substances. The manual is intended for both private and public sector healthcare vaccinators but some of the sections and examples are specific to the public sector because that is where the majority of childhood vaccinations are given. It will help healthcare workers to determine how much vaccine and related substances they need to run a successful immunisation facility, how to manage its storage, distribution and replacement. All facilities are expected to change to vaccine specific fridges if they have not yet done so because these fridges are designed to keep a more constant temperature and have a longer holdover time when there is power failure. These vaccine specific fridges are also more efficient and thus cost less to run. Much of the content and concepts in this manual reflect policy and documentation from WHO and UNICEF Expanded Programme on Immunisation (EPI).  Each facility should have a copy of this manual and make sure that vaccines are kept potent for vaccination against Vaccine Preventable Diseases.