Only around 1% of Nigeria’s 200 million people have been vaccinated against COVID-19. It is a worrying picture for this giant West African nation - especially if the highly transmissible Delta variant takes hold.
While Nigeria is experiencing vaccine supply problems, the most important issue is the lack of demand - driven in large part by mistrust and misinformation. There seems to be a widespread perception that COVID-19 is not real nor a serious health risk, with most people returning to large gatherings without face masks, physical distancing, or hand washing. Nigeria has significant experience with addressing widespread vaccine hesitancy, most notably with its successful polio vaccination campaign. The government can do this again if it musters the right persuasive tactics.
Surveys seeking to understand why Nigerians are wary point to lack of trust in the COVID-19 vaccine itself as well as the plethora of misinformation about the disease and the vaccine. Religious belief seems to be a factor in vaccine hesitancy with a number of respondents indicating that their faith prohibits them from taking it - echoing some early objections to the polio vaccine.
The risks associated are potentially very serious. With so few vaccinated, there is no population immunity and a risk of unchecked spread of the virus. This increases the risk of mutation and rise of variants of concern that can lead to a surge in cases and deaths as already seen in India and elsewhere. The first cases of the Delta variant have already been reported and the government says this could lead to another “wave” of cases in Nigeria.
The hesitancy in Nigeria could also be associated with past experiences with government health interventions. In 1996, 11 children in Kano State died during a meningitis clinical trial conducted by Pfizer. This bitter experience could also influence willingness to accept the COVID-19 vaccine.
There is no doubt that COVID-19 vaccines are saving lives. In countries where vaccination has been scaled up, there has been a decline in the number of cases and far fewer deaths and hospitalizations. Even if Nigeria avoids the worst consequences of the Delta variant, there will be other variants of concern. It is extremely important that Nigeria scales up vaccine uptake. Interventions must start now with over 40 million doses expected to arrive in the next three months.
We can draw on lessons from other campaigns, including our own vaccine history. As a child of the 1990s, I clearly remember “Kick Polio out of Nigeria”, a campaign launched by South African President Nelson Mandela in 1994 to eradicate polio in all African countries. There were radio and television jingles about the polio vaccine and promoting its effectiveness. There were posters all across the country, utilizing the buzz around the 1994 World Cup to sell the message further. Twenty years after the campaign, polio has finally been eradicated in Nigeria.
This year the United Kingdom picked up the football theme for COVID-19, introducing “Vaccine Days” and using the EURO 2020 football tournament as an attraction. Targeted particularly at young people, anyone can get vaccinated in football stadiums not being used for soccer games. I got my first dose of the COVID-19 vaccine near Wembley, on the day England played its first EURO 2020 football match against Croatia.
While the country is now recovering from the disappointment of their loss against Italy in the final, the excitement of visiting the famous Wembley stadium made it a very memorable experience and I am sure provided a great incentive to many people to get vaccinated. Surely the Nigerian Government can mobilise clubs and sports facilities do something similar, either linked to football or the Tokyo Olympics.
The private sector can also help. In the United States, Krispy Kreme is offering one free glazed doughnut to anyone with a proof of COVID-19 vaccination. In some parts of China, people are offered chicken wings, cartons of eggs and even free entry to parks for getting a vaccine. These small incentives, if well managed, could go a long way in increasing vaccine uptake.
Trusted individuals can also get the message across. The government needs to think creatively about this and do it quickly. Footballers, musicians and other well-known stars should deliver the message directly to communities as part of the broader communications strategy that goes beyond dull official statements. Officials, too, should be available to hear concerns, answer questions, and assure people of the safety and effectiveness of vaccines. This would go a long way to countering misinformation and encouraging more people to get vaccinated.
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Nigeria also needs keep working with COVAX and the African Union to procure more vaccines and step-up efforts to make these vaccines as accessible as possible, close to home, workplaces or even religious centers.
In other countries, slow rollout of vaccines has seen millions lose their lives. Strong as Nigerians are, we have to recognize the real risk of rapid COVID-19 outbreaks, high numbers of deaths and major economic loss. As a matter of urgency, the government, needs to scale up vaccine acceptance and ensure adequate vaccine supplies now.
Oyeronke Oyebanji, a Nigerian public health professional and 2021 Aspen New Voices Fellow, is Strategy Coordinator at the Coalition for Epidemic Preparedness Innovations and an Analyst at the COVAX Strategic Coordination Office. The views expressed in this opinion piece are those of the author.
