Last week marked the second occasion that a Controlled Temperature Chain (CTC) has been officially used with a vaccine licensed, pre-qualified, and labelled accordingly. Mauritania has just completed a Meningitis A immunization campaign (scheduled from October 14th to the 23rd) using the Meningococcal A conjugate vaccine, MenAfrivac. Two districts with particularly pronounced cold chain constraints were selected as appropriate candidates for a CTC approach: Rosso and Maghta Lahjar. Following dedicated training and microplanning, health care workers in these two districts were permitted to take the vaccine out of refrigeration up to four days prior to its use, significantly reducing the burdens they typically face to maintain the +2 to +8°C traditional cold chain. As per WHO guidelines and the vaccine’s labelling, MenAfriVac can tolerate temperatures of up to 40°C for a single cold chain excursion just prior to administration and not exceeding four days. Conducting a Meningitis A immunization campaign using the meningococcal A conjugate vaccine, MenAfriVac, in a controlled temperature chain (CTC). Mauritania, October 2014. Photos: WHO To date, Benin has been the only country to pilot the CTC approach, as it is defined by WHO, taking advantage of this cold chain policy variation during a Meningitis A campaign in December 2012. In addition to Mauritania, two more countries will be implementing a CTC approach with MenAfriVac before the end of 2014: Togo in November and Côte D’Ivoire in December. These additional experiences will provide a valuable opportunity to collect more data on CTC, as well as document best practices and draw out key lessons to apply to future efforts.