Cold chain emergencies

Dan Brigden

This page presents a list of resources that can help to improve the preparedness and response capabilities of health personnel in maintaining vaccine integrity during emergencies. Resources are organised as follows:

If you are aware of other resources that shold be listed, please contact the page curator listed above. 

Guidance on responding to temperature excursions

The following resources provide specific guidance on how staff can respond to temperature excursions, and can be used as source material when developing new guidance.

TitleAuthorYearTypeLanguage
Handbook for Vaccine & Cold Chain Handlers, 2nd editionIndia Ministry of Health and Family Welfare2016GuidanceEnglish
Vaccine Storage & Handling ToolkitCenters for Disease Control and Prevention (CDC)2024ToolEnglish
Responding to errors in vaccine storage, handling and administrationUK Health Security Agency2022GuidanceEnglish
The use of vaccines that have been temporarily stored outside the recommended temperature rangeUK Health Security Agency2019GuidanceEnglish
Management of temperature excursions with Janssen Covid-19 vaccineSouth Africa National Department of Health2021GuidanceEnglish
How to monitor temperatures in the vaccine supply chainUNICEF, World Health Organization (WHO)2015GuidanceEnglish, French

Job aids for healthcare workers

Job-aids provide concise instructions on how heathcare workers should perform a specific task. They are typically presented as one- or two-page documents that can be printed and displayed where the task will be performed. They can also be presented as short training videos. 

TitleAuthorYearTypeLanguage
What to Do When a Vaccine Refrigerator Breaks DownImmunization Academy2018TrainingEnglish
Packing Vaccines for Transport during EmergenciesCenters for Disease Control and Prevention (CDC)2010Poster/infographicEnglish
Checklist for emergency storage including power or refrigerator failureDepartment of Health and Aged Care, Australian Government2019GuidanceEnglish
Handling a Temperature Excursion in Your Vaccine Storage UnitCenters for Disease Control and Prevention (CDC)2000GuidanceEnglish

Forms for reporting temperature excursions

The following forms are used by healthcare workers in various countries report temperature excursions.

TitleAuthorYearTypeLanguage
Vaccine Cold Chain Incident Exposure/Wastage ReportOntario Government2020ReportEnglish
Cold Chain Breach (CCB) reporting formDepartment of Health and Aged Care, Australian Government2025ReportEnglish

Waste management in an emergency

TitleAuthorYearTypeLanguage
Four steps for the sound management of health-care waste in emergenciesWorld Health Organization (WHO)2000GuidanceEnglish
Guidelines for safe disposal of unwanted pharmaceuticals in and after emergenciesWorld Health Organization (WHO)1999GuidanceEnglish, French, Indonesian, Spanish

Template SOPs for responding to emergencies 

The EVM model SOPs provide detailed guidance on good practice for many of the routine tasks encountered in immunization logistics and to provide general guidance on writing and managing SOPs. Two model SOPs related to responding to emergencies are provided, which can be adapted and translated to suit local needs: Responding to emergencies in fixed storage locations (EVM-SOP-E3-01) and Responding to emergencies during vaccine transport operations (EVM-SOP-E7-06).

TitleAuthorYearTypeLanguage
EVM Model SOP manualWorld Health Organization (WHO)2013GuidanceEnglish, French

Country case studies

TitleAuthorYearTypeLanguage
Improving emergency preparedness of subnational vaccine stores in Ukraine: co-creation and implementation of on-site functional simulation exercisesYevgenii Grechukha, Soulemane Kone, Oleg Benes, Maricel Castro2026Journal articleEnglish

EVM requirements for health personnel 

Effective Vaccine Management (EVM) is a global initiative to increase immunization coverage through the continuous improvement of vaccine supply chains. EVM defines almost 900 requirements that a vaccine supply chain needs to meet. The following EVM requirements provide a good summary of the standards that needs to be met in ensuring health personnel are capable of handling cold chain disruptions. Click the link for details on each requirement. For a full list of EVM requirements that can be filtered by criteria and category, refer to the Setting the standard page of the EVM website.

Category Code Requirement
C4.3 Knowledge & understanding R0273 Responsible staff are knowledgeable of the contingency plans for power loss, refrigeration equipment breakdown, and other storage emergencies.
C4.3 Knowledge & understanding R0285 Responsible staff know the contingency plans for vehicle breakdown or other transport emergency.
C5.3 SOPs R0308 The facility has a vaccine storage emergency contingency plan.
C5.3 SOPs R0318 The facility has a vaccine transport emergency contingency plan(s).
C5.3 SOPs R0319 Vaccine transportation vehicles have vaccine transport emergency contingency plans.
Performance R0496 Appropriate action is taken to protect vaccines in the event of refrigeration equipment breakdown, power loss or other storage emergency.
Output R0627 Actions taken in response to vaccine transportation emergencies are recorded.