Assessing vaccine cold chain storage and transport in Ukraine: a cross-sectional study

Assessing vaccine cold chain storage and transport in Ukraine: a cross-sectional study | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Assessing vaccine cold chain storage and transport in Ukraine: a cross-sectional study Stanislav Gaievskyi, Yevgenii Grechukha, Oleg Khomenko, Nasrin Musa Widaa Musa, and 5 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-6612132/v1 This work is licensed under a CC BY 4.0 License Status: Published Journal Publication published 10 Mar, 2026 Read the published version in BMC Health Services Research → Version 1 posted 4 You are reading this latest preprint version Abstract Background: This study aimed to monitor risks of temperature excursions along vaccine distribution routes in Ukraine to identify weaknesses and recommend improvements. Methods: This cross-sectional study followed the World Health Organization’s temperature monitoring protocol. Vaccine shipments along randomly selected distribution routes were monitored using loggers, recording temperatures at 20 minutes intervals across all levels of the cold chain. The collected data were analysed to assess compliance with the recommended range and identify instances of heat and freeze exposure. Results : A total of 72040.1 hours were recorded from July 2024 to October 2024 across 48 distribution routes. The recorded temperature ranged from -13.6 o C to +28.4 o C. The level of compliance with the recommended temperature range varied by immunisation supply chain level and across facilities at a given level. The highest compliance (~100%) was observed at national and oblast stores and during transits between these levels. At the same time, the lowest compliance (88.8%) during storage was observed at primary healthcare centre (PHC) sub-offices, with three of such facilities failing to maintain the recommended range at any point during the study. Additionally, 20 freeze and five heat alarms were recorded at this level, indicative of prolonged exposures. During transits to PHC and sub-offices, compliance was achieved during 54.8% and 60.3% of the recorded time, respectively. Furthermore, eight transits to PHC and 15 to PHC sub-offices failed to maintain temperatures within the required range throughout the transit. Conclusions: While Ukraine’s vaccine cold chain system is effective at higher levels, temperature excursions were common at lower levels, particularly in PHC sub-offices and during transport to lower-level facilities. Equipment malfunctions, gaps in knowledge and lack of procedures, compounded by power outages and lack of power supply contingencies, are probable causes. Systematically identifying and documenting temperature excursions and assessing the potential damage to vaccines are recommended immediate actions. Providing further qualified equipment, ensuring resilient power supply, strengthening training, and improving procedures and supervision to prevent and mitigate risks of temperature excursion incidents are longer-term recommended actions. Implementing these actions would strengthen Ukraine’s immunisation supply chain resilience, ensuring safe and effective immunisation services. Vaccines Cold Chain Temperature Monitoring Ukraine Full Text Additional Declarations No competing interests reported. Cite Share Download PDF Status: Published Journal Publication published 10 Mar, 2026 Read the published version in BMC Health Services Research → Version 1 posted Editorial decision: Accepted 05 Mar, 2026 Editor assigned by journal 23 Oct, 2025 Submission checks completed at journal 31 Jul, 2025 First submitted to journal 30 Jul, 2025 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-6612132","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":546194419,"identity":"d25f0782-cef1-4b30-849b-a98598108bd2","order_by":0,"name":"Stanislav 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study","fulltext":[],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":false,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":true,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":true,"isAuthorSuppliedPdf":true,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":true,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"bmc-health-services-research","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"bhsr","sideBox":"Learn more about [BMC Health Services Research](http://bmchealthservres.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/BHSR/default.aspx","title":"BMC Health Services Research","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"Vaccines, Cold Chain, Temperature Monitoring, Ukraine","lastPublishedDoi":"10.21203/rs.3.rs-6612132/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-6612132/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eBackground:\u003c/strong\u003e This study aimed to monitor risks of temperature excursions along vaccine distribution routes in Ukraine to identify weaknesses and recommend improvements.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethods:\u003c/strong\u003e This cross-sectional study followed the World Health Organization’s temperature monitoring protocol. Vaccine shipments along randomly selected distribution routes were monitored using loggers, recording temperatures at 20 minutes intervals across all levels of the cold chain. The collected data were analysed to assess compliance with the recommended range and identify instances of heat and freeze exposure.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResults\u003c/strong\u003e: A total of 72040.1 hours were recorded from July 2024 to October 2024 across 48 distribution routes. The recorded temperature ranged from -13.6\u003csup\u003eo\u003c/sup\u003eC to +28.4\u003csup\u003eo\u003c/sup\u003eC. The level of compliance with the recommended temperature range varied by immunisation supply chain level and across facilities at a given level. The highest compliance (~100%) was observed at national and oblast stores and during transits between these levels. At the same time, the lowest compliance (88.8%) during storage was observed at primary healthcare centre (PHC) sub-offices, with three of such facilities failing to maintain the recommended range at any point during the study. Additionally, 20 freeze and five heat alarms were recorded at this level, indicative of prolonged exposures. During transits to PHC and sub-offices, compliance was achieved during 54.8% and 60.3% of the recorded time, respectively. Furthermore, eight transits to PHC and 15 to PHC sub-offices failed to maintain temperatures within the required range throughout the transit.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusions:\u003c/strong\u003e While Ukraine’s vaccine cold chain system is effective at higher levels, temperature excursions were common at lower levels, particularly in PHC sub-offices and during transport to lower-level facilities. 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Implementing these actions would strengthen Ukraine’s immunisation supply chain resilience, ensuring safe and effective immunisation services.\u003c/p\u003e","manuscriptTitle":"Assessing vaccine cold chain storage and transport in Ukraine: a cross-sectional study","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2026-02-27 18:55:00","doi":"10.21203/rs.3.rs-6612132/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Accepted","date":"2026-03-05T06:06:14+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2025-10-23T17:01:18+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2025-07-31T10:48:59+00:00","index":"","fulltext":""},{"type":"submitted","content":"BMC Health Services Research","date":"2025-07-30T16:00:46+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-health-services-research","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"bhsr","sideBox":"Learn more about [BMC Health Services Research](http://bmchealthservres.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/BHSR/default.aspx","title":"BMC Health Services Research","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"8260567b-e49b-438a-8b37-107765372e0a","owner":[],"postedDate":"February 27th, 2026","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"published-in-journal","subjectAreas":[],"tags":[],"updatedAt":"2026-03-16T16:02:19+00:00","versionOfRecord":{"articleIdentity":"rs-6612132","link":"https://doi.org/10.1186/s12913-026-14332-5","journal":{"identity":"bmc-health-services-research","isVorOnly":false,"title":"BMC Health Services Research"},"publishedOn":"2026-03-10 15:58:34","publishedOnDateReadable":"March 10th, 2026"},"versionCreatedAt":"2026-02-27 18:55:00","video":"","vorDoi":"10.1186/s12913-026-14332-5","vorDoiUrl":"https://doi.org/10.1186/s12913-026-14332-5","workflowStages":[]},"version":"v1","identity":"rs-6612132","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-6612132","identity":"rs-6612132","version":["v1"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}