Background: Immunization helps save a life, protect serious illness, and improve quality of life. It is recognized as one of the most cost-effective public health interventions available around the globe. However, the success of this program is heavily dependent on strong immunization supply chain practices. Proper immunization supply chain management ensures availing potent and live vaccines to the community.

Objective: To evaluate the application of effective vaccine management in health facilities of Wassit Governorate, Iraq.

Subjects and Methods: It was a cross-sectional study involving a multistage sampling. A total of 45 health facilities sites were selected, as follows: one sub-national store (SN), six district store (LD), and thirty eight service point (SP) by using effective vaccine management (EVM) questionnaire, interview, reviewing the records, and observations for the agreed review period. 

Results: The overall scores of this assessment for all levels (SN, LD, and SP) of the supply chain 66.6% demonstrates a need for more improvement in most areas of the vaccine and supply management system as only two criteria (storage capacity E3 and vaccine management practices E8) exceeds the WHO recommended minimum score of 80%. Performance levels of one criteria (building, equipment E4) were about 72% storage temperature (E2), maintenance(E5) and stock management (E6) were between 61 and 68%, while the vaccine distribution (E7), and information management (E9) were notably very weak with performance in each category less than 60%.

Conclusions: The national average percentage at all levels was below the WHO recommended minimum score of 80%.

Recommendation: The future vaccine storage capacity must be recalculated and stored to enter any new vaccine, receive large quantities of the influenza vaccine, and replace vaccine refrigerators at the sector level with cold rooms to accommodate current and future increases.