There are few immunization issues more important than the appropriate storage and handling of vaccines. The success of efforts against vaccine-preventable diseases is attributable in part to proper storage and handling of vaccines. Vaccines exposed to temperatures outside the recommended ranges can have reduced potency and protection. Storage and handling errors can cost thousands of dollars in wasted vaccine and revaccination. Errors can also result in the loss of patient confidence when repeat doses are required. It is better to not vaccinate than to administer a dose of vaccine that has been mishandled. Vaccine management, including proper storage and handling procedures, is the basis on which good immunization practices are built.Vaccines must be stored properly from the time they are manufactured until they are administered. Assuring vaccine quality and maintaining the cold chain is a shared responsibility among manufacturers, distributors, public health staff, and health-care providers. A proper cold chain is a temperature-controlled supply chain that includes all equipment and procedures used in the transport and storage and handling of vaccines from the time of manufacture to administration of the vaccine. By following a few simple steps and implementing best storage and handling practices, providers can ensure that patients will get the full benefit of vaccines they receive.