Transport of Immunobiologicals in Brazil: A Multiple Case Study

<i>Background</i>: Immunobiologicals are thermolabile products that require strict storage and transportation conditions to maintain their immunogenic efficacy, particularly in countries where logistical and operational challenges are evident, such as Brazil. <i>Methods</i>: A holistic multiple case study, carried out in five regions of Brazil, in 2022, with 42 workers from different instances of the cold chain was conducted. As a source of evidence, data were collected through interviews and analysis of printed documents and analyzed using Thematic Content Analysis, using the analytical technique of cross-case synthesis. <i>Results</i>: The influence of geoclimatic diversity and transportation modes on immunobiological logistics was highlighted. Challenges and requirements were identified, as well as aspects of monitoring during transportation and distribution. Among the main challenges were long distances, poor road conditions, seasonality and the need to share vehicles due to the unavailability of exclusive transportation. Conversely, positive practices were highlighted, such as the use of air-conditioned vehicles, dataloggers and properly prepared thermal boxes. <i>Conclusions</i>: It is necessary to adopt mitigation strategies that consider regional inequalities and promote equity, through raising awareness among managers, investing in logistical infrastructure and expanding good practices in order to guarantee the universal and qualified distribution of immunobiologicals in the country.