Vaccine Cold Chain Performance Across Seven Provinces and Two Seasons in Nepal: Findings from a Nationwide Temperature Monitoring Study

This study assessed vaccine cold chain performance in Nepal through a nationwide Temperature Monitoring Study conducted across all seven provinces during winter and summer 2025. Temperature loggers tracked vaccines from the Central Vaccine Store to health facilities. Overall, vaccine storage and transport conditions were strong, with vaccines maintained within the recommended 2–8 °C range for more than 97% of monitored time in both seasons. However, route-level analysis identified episodes of freezing and overheating, particularly during transport and last-mile distribution. Freeze exposure was concentrated in cold boxes and vaccine carriers, while heat exposure increased markedly during summer. The authors recommend targeted operational improvements, including better ice-pack conditioning, transport practices, equipment maintenance, and temperature monitoring, to further strengthen Nepal’s immunization supply chain and protect vaccine potency.

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