With the overarching aim to sustain high immunization coverage in Bhutan, the 2022 edition of the EPI manual addresses the change in need surrounding immunization services that have emerged in the past two years. Over the past three years, COVID-19 vaccines have been developed and introduced to prevent or reduce disease severity in response to the pandemic that has affected and taken millions of lives globally. Vaccines such as the Pfizer, Moderna, AstraZeneca, CoviShield and Sinopharm are well covered in this manual to assist service providers in contributing towards the battle against COVID-19. In this edition, the chapter dedicated to managing vaccines and cold chain has been revised and elaborated into two distinct chapters namely Vaccine Management and Maintenance of Cold Chain Equipment. A distinct feature of this edition is the emphasis that has been placed not only on vaccine management but also on the maintenance and repair of cold chain equipment which is of equal significance for ensuring vaccine potency and sustaining optimum quality service delivery in the field of immunization. In the 2022 edition, the chapter on Ensuring Safe Injection also prioritizes waste management resulting from vaccines to ensure proper disposal of immunization wastes.
This manual aims to provide the service providers with adequate and accurate knowledge on the use of cold chain equipment and temperature monitoring devices. Hence, the chapter on Cold Chain Equipment consists of the detailed types of cold chain equipment and description of its components. To ease the monitoring and maintenance process, a chapter on Documentation and Reporting has been included. The standard format for documentation, budgeting and reporting included in this chapter would not only ensure uniformity in the data given by service providers residing in different parts of the country but would also ease the process of indent and management of the vaccines and equipment thereby easing the process of service delivery of immunization as a whole.

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• Policies and SOPs for vaccine management

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