Nigeria: The Challenge of Routine Immunisation

24 July 2024

The health authorities should ensure all children are immunised and protected

There are growing indications that Nigeria 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. 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. 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 which has warned of a "child survival crisis" on the continent. It is an admonition that authorities in our country must heed.

The Paediatric Association of Nigeria's president, Ekanem Ekure recently lamented the high number of zero-dose children in our country. "The statistics of children who have received all the vaccines in the national programme is 23 per cent which is low. It is not surprising that our under-five mortality rate is so high," said Ekure who disclosed that most of these children are located in urban slums, conflict areas, and remote and hard-to-reach communities. "We have the highest under-five mortality rate in the world, and unfortunately, these children are dying from diseases that can be prevented, for which the government has made vaccines available for free."

Due to the security challenge that plagues the nation, routine immunisation, and the inability to access certain areas remains a major problem. It is however noteworthy that the Minister of Health and Social Welfare, Mohammed Pate, has been proactive on the issue of children immunisation. In April this year, Nigeria became the first country in the world to roll out a new vaccine (called Men5CV) recommended by the World Health Organisation (WHO), which protects people against meningitis. But Pate needs the support of other stakeholders, including the media, religious and traditional leaders as well as the civil society.

We encourage these critical actors to rise to the challenge so that we can quickly deal with this problem. Meanwhile, health officials in all parts of Nigeria, whether north or south, need to redouble their efforts to improve the coverage level of childhood immunisation and other child survival issues that plague the Nigerian child. Given how we successfully fought Polio, there is nothing to suggest we cannot overcome this challenge, especially if we mobilise the civil society, religious and traditional leaders as well as our dedicated health workers at local levels.

In its most recent report, the United Nations Children's Fund (UNICEF) had revealed that 67 million children across the world missed out on either some or all routine vaccinations between 2019 and 2021. Not surprisingly, half the total number of unvaccinated children is in Africa. More disturbing is that on the number of children at the risk of death and vaccine-preventable diseases, Nigeria is second only to India. "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.

Immunisation as a measure used to track progress towards lowering child morbidity and mortality, one of the most cost-effective public health initiatives. It is thus essential that the health authorities in Nigeria do more to ensure that all children are immunised and protected. Government at all levels as well as other critical stakeholders must also act 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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