Vaccines are sensitive to temperature, so storage temperatures above 8 °C (frozen temperature-sensitive vaccine) or below -25 °C (heat-sensitive vaccine) will damage the vaccine and will lose its effectiveness. Vaccines need a cold chain that controls the temperature and humidity of the vaccine to maintain its potentiality starts from manufacture to the patient. Stakeholders must follow standard cold chain management procedures consistently because cold chain cycles require strict temperature and humidity controls. Negligence that occurs in the vaccine supply chain can damage the vaccine and can also endanger users. Because of the importance of the vaccine supply chain and the many risks that may occur, a risk management framework in the vaccine supply chain is needed. This study presents the initial stages of supply chain risk management, risk identification. There are two steps to the methodology used to identify elements of a vaccine supply chain risk. The first step is to use the literature review, and the second step is a discussion and validation from the expert. The results showed that there were 33 risk elements of the vaccine supply chain.