Nigeria’s Immunisation Challenge: How to Reach Zero-Dose Children and Combat Vaccine-Derived Polio
Nigeria continues to face significant challenges in reaching unvaccinated children and containing the spread of circulating vaccine-derived poliovirus type 2 (cVDPV2), despite years of intervention efforts.
The Scale of the Problem
According to UNICEF data, Nigeria has the world’s highest number of unvaccinated children, with approximately 2.1 million children under one year old (24% of the country’s 8.7 million under-one population) having never received any routine vaccines.
Christiana Fashola, a global digital health and vaccine expert with experience across Africa, Central Asia, and Latin America, emphasizes that Nigeria must evolve its immunization strategies to close these critical coverage gaps.
Lessons from Global Best Practices
Ms. Fashola highlights several key strategies that could improve Nigeria’s immunization outcomes:
1. Community-Based Service Delivery
“There’s a growing need to expand beyond traditional strategies by leveraging community-based service delivery models,” Fashola explains. This includes integrating community pharmacies into vaccine delivery systems, particularly in hard-to-reach areas.
2. Intersectoral Collaboration
The expert points to successful models that combine health, education, and social services, as demonstrated during COVID-19 and HPV vaccine rollouts. Local influencers, mobile teams, and community health workers remain essential for reaching underserved populations.
3. Trust-Building Measures
“If people don’t trust the system, they won’t take the vaccines,” Fashola stresses, emphasizing the need for culturally sensitive communication approaches.
Understanding the cVDPV2 Challenge
Recent outbreaks reveal systemic weaknesses in Nigeria’s vaccine distribution, particularly in conflict-affected and remote regions. Key contributing factors include:
- Low immunization coverage
- Poor sanitation infrastructure
- Critical shortage of health workers (1.83 per 1,000 people vs WHO’s recommended 4.45)
- Persistent vaccine hesitancy
Reaching Zero-Dose Children
As the World Health Organization marks 50 years of its Expanded Programme on Immunization (EPI), Nigeria still struggles to vaccinate children in northern regions due to:
- Security challenges
- Limited healthcare access
- Misinformation about vaccines
While mobile outreach programs and traditional leader engagement have shown promise, Fashola notes that stronger data systems, improved infrastructure, and timely funding releases are needed to make significant progress.
The Path Forward
To build a resilient immunization system, Nigeria must:
- Increase investment in health workforce training and deployment
- Scale up digital tools like geospatial mapping for vaccine delivery
- Strengthen partnerships with global health organizations (Gavi, WHO, UNICEF)
- Improve water and sanitation infrastructure
- Enhance monitoring and evaluation systems
“Nigeria has successfully integrated global immunization strategies by adapting proven approaches to local contexts,” Fashola concludes. “The focus now must be on sustainable financing, knowledge sharing, and domestic resource mobilization.”