The success of the Expanded Programme on Immunization (EPI) over the years is attributed to the immunization supply chain, effective logistics systems, and the health professionals who run them. Gaps in knowledge and practices still exist in developing countries and countries with conflict. Due to the paucity of information regarding the subject in humanitarian settings, this study was carried out. This descriptive cross-sectional study was carried out among health workers at the four levels of the healthcare system in 6 governorates in Yemen. A total of 536 health workers provided responses to the online questionnaire between February and May 2022. The study showed that 515(96.1%) and 521(97.2%) of the respondents, respectively, knew the recommended temperature range for storage of Rota and pentavalent vaccines at the health facility. Most respondents, 415(77.4%) and 413(77.0%) knew the recommended storage temperature for measles and BCG, respectively, and 466(86.9%) knew they could be stored at a negative temperature when the need arises. Over two-thirds of respondents only receive vaccines 411(76.7%), and 124(23.1%) receive and distribute vaccines. Vaccine distribution included the use of refrigerated vehicles (15.2%), cold boxes (32.8%), and vaccine carriers (41.6%), both with conditioned ice packs. Despite the protracted and complex humanitarian situation in Yemen, Health workers demonstrated good knowledge and practices of vaccine storage, distribution, and cold chain management, which contributed to the sustenance of immunization services. There is a need for required investment in a cost-effective and sustainable last-mile vaccine distribution approach to ensure equitable availability of vaccines at health facilities and prevent any missed opportunity. Keywords: Cold chain, Distribution, Vaccine storage, Knowledge.
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