Nigeria: The Case for Routine Immunisation

17 June 2024

The authorities must do more to ensure that all children are immunised and protected

A recent warning by the United States Centre for Disease Control (USCDC) that Nigeria risks an outbreak of vaccine-preventable diseases should be taken seriously. According to the centre which has advocated urgent action to close the wide immunisation gap, Nigeria accounts for the highest-burden of unsaturated children globally, with 2.3 million zero-dose children. These are children who are yet to receive the first dose of diphtheria, tetanus, and pertussis vaccine. The USCDC report corroborates 'The State of the World's Children 2023,' by the United Nations Children's Funds (UNICEF) which revealed that 2.2 million children in Nigeria have never received a vaccination. Perhaps more disturbing is that on the number of children at the risk of death and vaccine-preventable diseases, Nigeria is second only to India.

Largely responsible for interrupted childhood vaccination across the world was the Covid-19 pandemic. According to UNICEF, the intense demands on health systems, the diversions of immunisation resources, health worker shortages and stay-at-home measures all contributed to missed vaccinations. These are in addition to conflicts, climate change and vaccine hesitancy. But the challenge was more because public perception of the importance of vaccines declined and further exacerbated the persistent weaknesses in health systems and primary healthcare. "We cannot allow confidence in routine immunisations to become another victim of the pandemic. Otherwise, the next wave of deaths could be of more children with measles, diphtheria, or other preventable diseases," UNICEF Executive Director, Catherine Russell warned.

No fewer than 34 of the 54 countries in Africa experienced disease outbreaks such as measles, cholera, and poliovirus last year, according to figures from UNICEF that has warned of a 'child survival crisis.' In Nigeria, even if statistics are not reliable, there have been a wave of measles, cholera, and other preventable diseases. Indeed, there is a current outbreak of cholera which has claimed many lives, and still spreading across the states.

Before the COVID-19 pandemic's disruption, Nigeria was making progress, albeit slowly in childhood immunisation. Data from the Nigerian Democratic and Health Survey (NDHS) revealed that the percentage of children that have received all basic vaccinations increased from 13 per cent in 2003 to 31 per cent in 2018. Even so, Nigeria still has a lot to do to meet the Sustainable Development Goals' target of achieving more than 90 per cent coverage of all basic vaccinations among children aged 12-23 months. Besides, the country's childhood vaccination coverage also falls short of Global Vaccine Action Plan (GVAP) targets, making many children vulnerable to death and vaccine-preventable diseases.

We understand that because of the security challenge that plagues the nation, routine immunisation, and the inability to access certain areas remains a major problem. But we encourage all critical stakeholders to rise to the challenge so that we can quickly deal with this problem. Health officials in all parts of Nigeria need to redouble their efforts to improve the coverage level of childhood immunisation and other child survival issues that plague the Nigerian child. We should mobilise the civil society, religious and traditional leaders as well as our dedicated health workers at local levels to tackle the challenge.

Immunisation as a measure used to track progress towards lowering child morbidity and mortality is one of the most cost-effective public health initiatives. It is thus essential that the health authorities in Nigeria must do more to ensure that all children are immunised and protected. Government at all levels as well as other critical stakeholders must act now to 'catch up' with those missed vaccinations to prevent more deadly disease outbreaks. More importantly, there is an urgent need to intensify education and awareness of the deadly consequences of avoiding childhood vaccinations. Prevention, which is the whole idea of vaccination, as the old saying goes, is better than cure.

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