Maintaining effective and fair vaccine distribution via temperature-controlled logistics is crucial for healthcare systems, especially when dealing with perishable products requiring strict climate control. Practical obstacles, such as fluctuating demand, spoilage monitoring needs, and expensive logistics, complicate operations. This research presents an optimization framework that combines depot selection, stock management, delivery routing, and expiration factors to address these issues. The solution seeks to reduce overall expenses while maintaining equitable access for all recipients, handling various vaccine formulations across multiple time frames. Parameter sensitivity tests evaluate how storage limits and demand variations impact performance. Findings confirm the model’s ability to boost both economic performance and allocation equity, offering practical guidance for immunization logistics managers.