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PurposeThe already-strained vaccine supply chain (VSC) of the expanded program for immunization (EPI) require a more robust and structured distribution network for pandemic/outbreak vaccination due to huge volume demand and time constraint. In this paper, a lean-agile-green (LAG) practices approach is proposed to improve the operational, economic and environmental efficiency of the VSC.Design/methodology/approachA fuzzy decision framework of importance performance analysis (IPA)–analytical hierarchy process (AHP)–technique for order for preference by similarity in ideal solution (TOPSIS) has been presented in this paper to prioritize the LAG practices on the basis of the influence on performance indicators. Sensitivity analysis is carried out to check the robustness of the presented model.FindingsThe derived result indicates that sustainable packaging, coordination among supply chain stakeholders and cold chain technology improvement are among the top practices affecting most of the performance parameters of VSC. The sensitivity analysis reveals that the priority of practices is highly dependent on the weightage of performance indicators.Practical implicationsThis study's finding will help policymakers reframe strategies for sustainable VSC (SVSC) by including new management practices that can handle regular immunization programs as well as emergency mass vaccination.Originality/valueTo the best of the authors' knowledge, this is the first study that proposes the LAG framework for SVSC. The IPA–Fuzzy AHP (FAHP)–Fuzyy TOPSIS (FTOPSIS) is also a novel combination in decision-making.

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