Keeping vaccines and medicines at the right temperature is critical for their efficacy and safety. But this is an often overlooked part of getting them to the people who need them. In April 2025, the UK biotechnology company Stablepharma began the first human trial of a tetanus-diphtheria vaccine designed to remain stable without refrigeration. The development has renewed interest in technologies that could do the job, particularly in places where electricity, transport, and storage infrastructure are limited. We spoke to immunisation experts Charles Shey Wiysonge and Chinwe Juliana Iwu-Jaja about this.