Title : Assessing the impact of climate change on vaccine cold chain integrity and immunization service delivery in bushenyi district western Uganda: A cross-sectional study

Background: Climate change poses an increasing threat to healthcare systems, particularly vaccine cold chain management in low- and middle-income countries. Rising temperatures, erratic weather patterns, power interruptions, and extreme climatic events can compromise vaccine storage conditions, resulting in reduced vaccine potency and interruptions in immunization services. Although Uganda has made significant progress in expanding immunization coverage, evidence on the resilience of vaccine cold chain systems to climate-related challenges remains limited, particularly in Western Uganda. This study aims to assess the impact of climate change on the integrity of the vaccine cold chain and immunization service delivery in primary health facilities in Bushenyi district Western Uganda.

Methods: A facility-based cross-sectional study will be conducted among primary health facilities involved in vaccine storage and immunization services in Bushenyi, Western Uganda. Data will be collected through structured observation checklists, document reviews, and interviewer-administered questionnaires. The study will assess the availability and functionality of cold chain equipment, vaccine storage conditions, documentation practices, temperature monitoring systems, and the knowledge and practices of cold chain personnel. Climate-related factors, including power outages, ambient temperature fluctuations, and backup energy availability, will also be evaluated. Descriptive and inferential statistical analyses will be performed using STATA version 13, with statistical significance set at p < 0.05.

Expected Results: The study is expected to identify climate-related vulnerabilities affecting vaccine cold chain systems, including inadequate cold chain infrastructure, unreliable electricity supply, insufficient backup power sources, and gaps in temperature monitoring and documentation. These factors are anticipated to increase the risk of vaccine exposure to inappropriate temperatures, potentially compromising vaccine potency and immunization service delivery.

Conclusion: The findings will provide evidence to support climate-resilient vaccine cold chain management strategies in Uganda. The study is expected to inform policymakers, immunization programme managers, and regulatory authorities on strengthening cold chain infrastructure, improving emergency preparedness, enhancing healthcare worker capacity, and ensuring uninterrupted delivery of potent vaccines despite increasing climate-related challenges.

Keywords: Climate change; Vaccine cold chain; Immunization; Vaccine storage; Public health; Health systems; Uganda.

Omara Tonny is a 2nd-year student of MSc Pharmacology and Pharmacist at Kampala International University, Uganda, with over five years of experience in hospital pharmacy and biomedical research. His research interests include pharmacology, phytomedicine, vaccine sciences, pharmacogenomics, bioinformatics, and drug discovery. He has contributed to multidisciplinary research in infectious diseases, molecular pharmacology, and healthcare systems strengthening. He was awarded the Best African Pharmacy Student during the 2024 University of Indonesia Phytomedicine Program for outstanding academic performance.