Cutting costs, boosting confidence: a data-first approach to cold chain maintenance
When it comes to vaccination, the stakes are too high not to know exactly where the weak link lies.
- 17 March 2026
- 4 min read
- by JSI
You can’t manage what you can’t keep an eye on. That’s as true for vaccine cold chain equipment (CCE) as it is for national economies, rush hour traffic, or chess pieces on a board.
Real cool
Vaccines are finicky. Most routine childhood vaccines need to be kept constantly at a temperature of between 2°C and 8°C, even as they undertake complex voyages, crossing oceans in airplanes, meandering over provinces in trucks, and from rural towns to remote villages in passive cool-boxes shouldered by last-mile health workers. Also, during the sometimes months-long pauses between legs of that journey, vaccine vials need reliable, temperature-secure storage.
The chain is surprisingly easy to break: in a country as warm as summertime Ethiopia, a faulty fridge can start to fall out of the 2–8°C range in just eight hours, despite top-tier insulation, threatening the viability of every vaccine dose it contains.
Over the past decade, Gavi has invested more than US$ 250 million in CCE around the world, to ensure vaccines maintain quality and efficacy all the way to the last mile. But how can health systems truly be sure that each link in this chain of expensive equipment has functioned correctly, such that every vaccine is safe and potent at its destination?
Real-time
In Ethiopia, JSI and the Ministry of Health introduced technology that makes temperature data easily available. In Tigray and Oromia, areas contending with high security risks, regional health bureaus manage immunisation programmes in over 2,000 health facilities. Most CCE in these facilities has 30-day temperature loggers (also known by their commercial name as FridgeTags) that track temperature, and sound the alarm when the equipment falls or rises out of the ideal temperature range. But the challenge has been how to get that temperature data to the people who are in a position to actually do something about a broken-down fridge.
Credit: JSI
Enter the Varo/Pogo-LT app, which transforms previously isolated temperature data, locked within the FridgeTag, into actionable insights.
The app sends detailed diagnostic reports to technicians based at the regional health bureaus. The data allows the technicians to remotely pre-diagnose failures to narrow down potential causes, such as a solar panel needing an adjustment, or a compressor that is malfunctioning, and bring the correct spare parts on their first trip out to the facility facing the outage, eliminating redundant travel, cutting costs and dramatically accelerating the repair and maintenance cycle for CCE.
“At Bulala Health Centre, the gap between monitoring temperature and taking action used to be a significant vulnerability for our cold chain,” says Worknesh Ali, the centre’s EPI Focal Person. “Using the Varo/Pogo-LT app changed that. Reviewing FridgeTag data, I confirmed a failing primary refrigerator. I immediately activated our contingency plan, moving the at-risk vaccines to a secondary unit. Precise data facilitated swift, targeted repair. This action ensured every child in Diksis Woreda received a potent vaccine, protecting community health.”
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Most of the time, the app transmits reassuring news. Over the course of a single month, JSI reviewed reports from over 200 facilities in Oromia and Tigray and found that the fridges were working 95% of the time.
But as expected, some fridges did see temperature alarms go off. In those cases, the JSI team initiated targeted follow-up, and discovered that no vaccines had been left at risk, because health workers on the scene had followed protocols and had shifted vaccines to a different, temperature-secure CCE unit while the equipment was being repaired.
Having easy-access data meant the CCE management team could prioritise maintenance for the handful of CCE units that were not working.
This experience demonstrates the power of data visibility to safeguard essential investments. By linking CCE data directly to informed action, immunisation programmes can move beyond simply procuring and placing equipment, and responding to breakdowns, to actively managing performance and maximising vaccine efficacy at the last mile.
This approach not only ensures every dollar spent delivers maximum impact, but clearly demonstrates the value in collecting, collating and using data to secure a robust and resilient immunisation supply chain now and for the future.
