Vaccination now offers a way to resolve the COVID-19 pandemic. However, it is critical to recognise the full energy, environmental, economic and social equity (4E) impacts of the vaccination life cycle. The full 4E impacts include the design and trials, order management, material preparation, manufacturing, cold chain logistics, low-temperature storage, crowd management and end-of-life waste management. A life cycle perspective is necessary for sustainable vaccination management because a prolonged immunisation campaign for COVID-19 is likely. The impacts are geographically dispersed across sectors and regions, creating real and virtual 4E footprints that occur at different timescales. Decision-makers in industry and governments have to act, unify, resolve, and work together to implement more sustainable COVID-19 vaccination management globally and locally to minimise the 4E footprints. Potential practices include using renewable energy in production, storage, transportation and waste treatment, using better product design for packaging, using the Internet of Things (IoT) and big data analytics for better logistics, using real-time database management for better tracking of deliveries and public vaccination programmes, and using coordination platforms for more equitable vaccine access. These practices raise global challenges but suggest solutions with a 4E perspective, which could mitigate the impacts of global vaccination campaigns and prepare sustainably for future pandemics and global warming.