Immunization programs are highly dependent on an effective and efficient supply chain system for storing, transporting, and distributing vaccines. This ensures that the right products are available in the right place, at the right time, and under the right conditions to provide efficient health services to the public. This study aims to evaluate the implementation of Effective Vaccine Management (EVM) in Central Java and identify its obstacles. This study used a quantitative method with a cross-sectional approach. A descriptive analysis of vaccine management was carried out in 35 regencies/cities in Central Java. The population comprised EVM programmers in Central Java selected using the total sampling technique. Data were collected using the World Health Organization (WHO) assessment tools and in-depth interviews with pharmacy departments or person in charge of immunization programs in each regency/city. The results showed that five of the 35 regencies/cities had an average score of 80% and above across nine assessment indicators, but no region met the WHO standards of 80% across all the criteria assessed. The overall EVM assessment revealed that 20% of the regencies/cities fell into the low category, 65.7% in the medium category, and 14.3% in the high category. Each region had different problems in fulfilling the nine criteria of EVM assessment, such as inadequate infrastructure, lack of periodic vaccine stock recording, absence of standard operating procedures, and insufficiently trained officers. Therefore, support is needed from the Central Java Provincial Government in providing support to the regions with regular monitoring and evaluation of the EVM implementation. Additionally, officers need to be trained regarding proper vaccine management.