No cold chain, no immunization

UNICEF's long-running efforts to assess, expand and strengthen Nepal’s cold chain capacity are proving crucial to the delivery of vaccines around the country as part of the ongoing COVID-19 vaccination campaign

UNICEF Nepal
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UNICEF Nepal/2021/LPNgakhusi
06 April 2021

“Getting the vaccines themselves is one part of the work, but without proper storage and transport systems, it’s not possible to take them to the community.”

Bade Babu Thapa, Senior Pharmacy Officer
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UNICEF Nepal/2021/PShrestha
Bade Babu Thapa (right) with UNICEF cold chain consultant Nawaraj Khadka (left) in a cold room at the Central Vaccine Store under the Department of Health Services in Kathmandu.

“Getting the vaccines themselves is one part of the work, but without proper storage and transport systems, it’s not possible to take them to the community”, says Bade Babu Thapa, Senior Pharmacy Officer at the Central Vaccine Store in Kathmandu, under the Government of Nepal’s Department of Health Services, while talking about the importance of a strong cold chain – which refers to a series of precisely coordinated events in temperature-controlled environments to store, manage and transport vaccines – in ensuring the success of any immunization campaign. The Central Vaccine Store is the national-level facility responsible for storing and dispatching vaccine supplies across the country for use in immunization programmes at the community level.

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UNICEF Nepal/2021/LPNgakhusi
Mitthi Jirel, staff at the District Hospital in Dolakha District in northeastern Nepal, puts vaccines into a refrigerator provided by UNICEF in the hospital's vaccine store room.
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UNICEF Nepal/2021/LPNgakhusi
Mitthi Jirel (left) staff at the District Hospital in Dolakha District in northeastern Nepal, with UNICEF staff Preena Shrestha in the hospital's vaccine store room.

Recognizing the critical role played by a well-connected cold chain, UNICEF – since the very beginning of national immunization efforts in Nepal – has been working closely with the government and key partners such as Gavi to assess, expand and strengthen the country’s cold chain capacity.

This has included installation of cold rooms, refrigerators and freezers in vaccine storage facilities at the central, provincial, district and local levels, refrigerated containers for transportation, as well as supply of cold boxes and carriers to safeguard vaccines during the final leg of their journey to immunization sites. UNICEF also provides technical and logistical support at federal, provincial/district and local levels for effective vaccine and cold chain management.

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UNICEF Nepal/2021/LPNgakhusi
Shiva Ram Basnet, Cold Chain Officer at the District Public Health Office in Dolakha District in northeastern Nepal removes a box of COVID-19 vaccines stored in a refrigeration unit installed with UNICEF support following the 2015 earthquake

The support was further strengthened after the 2015 earthquake, which severely impacted health facilities around the country. For instance, in Dolakha District in northeastern Nepal, which was one of the worst-hit areas in the disaster, additional cold chain equipment and assistance was provided to many health facilities.

“The equipment from UNICEF has been in continuous use over the years for storing vaccines for routine immunization,” says Shiva Ram Basnet, cold chain officer at Dolakha’s Public Health Service Office. “It is designed to keep running even if the power supply is intermittent, which was often the case after the earthquake.”

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UNICEF Nepal/2021/LPNgakhusi
A health worker from the Patan Academy of Health Sciences receives the COVID-19 vaccine at Patan Hospital in Lalitpur District in central Nepal.

Today, with the launch of the vaccination drive against COVID-19 in Nepal, these long-running efforts to reinforce the cold chain have never been more crucial.

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UNICEF Nepal/2021
A refrigerated container carrying COVID-19 vaccines
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A healthworker at the Kalyanpur Primary Health Care Centre in Saptari District in Nepal's southern plains prepares to administer COVID-19 vaccines

“The COVID-19 vaccination drive is the most extensive vaccination program not just in the country but the whole world because it is targeting all adults, everywhere,” says Pradeep Shrestha, Health Officer at UNICEF Nepal. “We are happy that the work UNICEF has put into the vaccine and cold chain management over all these years is helping in the roll-out.”

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Health officials and UNICEF staff move a newly-arrived cold box of COVID-19 vaccines across the runway at the Jumla Airport in Nepal's far-west
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Health officials at the Pandugufa Health Post in Jumla District in farwestern Nepal, storing COVID-19 vaccines in a refrigeration unit
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COVID-19 vaccines in a cold box provided by UNICEF being carried by a porter on foot to a vaccination site in Jumla District in far-western Nepal

And the efforts to strengthen the cold chain are continuing. In 2020 alone, UNICEF installed 290 pieces of cold chain equipment in different facilities nationwide. Plans are also in place to procure and install an additional 910 pieces to address still-existing gaps in select areas and facilitate smooth delivery of vaccines.

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UNICEF Nepal/2021/LPNgakhusi
Bal Kumari Khadka, Cold Chain Assistant at the District Vaccine Store in Jumla District in Nepal’s remote far-western region storing vaccines in a refrigerator installed with UNICEF support at the facility

“We’re very thankful for UNICEF’s support,” says Bal Kumari Khadka, Cold Chain Assistant at the District Vaccine Store in Jumla District in Nepal’s remote far-western region. "The fact that we have been able to run the vaccination campaign here simultaneously with other places around the country shows how important the cold chain system is in increasing vaccine coverage.”

The cold chain will also be used to store, transport and distribute vaccines received through the COVAX Facility, a partnership between CEPI, Gavi, UNICEF and WHO, made possible through generous donor support from governments, international organizations, foundations and the private sector. Nepal received its first consignment of COVID-19 vaccines - a total of 348,000 doses - that were shipped through the COVAX facility on 7 March 2021, in support of the Government of Nepal’s nation-wide vaccination campaign. 

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Seventy-year-old Maisuri Rawat from Jumla District in far-western Nepal shows her vaccination card after receiving the COVID-19 vaccine in the second phase of the drive