Nigeria’s immunisation levels have failed to grow for the past four years, compared to pre-pandemic levels in 2019, excluding many children from essential protection, according to data published on Tuesday by the World Health Organization (WHO) and UNICEF.
Trends in vaccine coverage since 2020 show that none of the 15 vaccines in the national immunization schedule achieved coverage of 90 percent or more as vaccine coverage ranged from 12 percent to 74 percent.
Despite the addition of RotaC, a new vaccine introduced in 2022 and achieving 49 per cent coverage in 2023, vaccine coverage in 2023 still ranged only from 38 per cent to 74 per cent.
“The latest trends demonstrate that many countries continue to miss far too many children,” said UNICEF executive director Catherine Russell. “Closing the immunization gap requires a global effort, with governments, partners, and local leaders investing in primary healthcare and community workers to ensure every child gets vaccinated, and that overall healthcare is strengthened.”
DTP3
According to the findings, the number of children who received three doses of the vaccine against diphtheria, tetanus and pertussis (DTP3) in 2023 – a key marker for global immunization coverage – stalled at 62 per cent.
This level was 22 percentage points lower than the global average of 84 per cent and seven percentage points lower than the average across all WCAR countries at 69 per cent.
Nigeria’s national DTP3 coverage dropped four percentage points compared to 2019, falling to 66 per cent. This translates to a 3 per cent decrease in the number of children vaccinated with DTP3.
In 2023, Nigeria ranked number four out of 24 countries for lowest DTP3 coverage and was in the top 10 countries with the most un- and under-vaccinated children.
Although the number of surviving infants increased approximately four per cent in 2023 with 300,000 more surviving infants than, 100,000 fewer children were vaccinated in 2023 than in 2019.
For vaccine coverage to increase, the WHO and UNICEF suggest that the number of vaccinated children must grow faster than the population increases.
According to Muhammad Pate, Nigeria’s minister of Health and Social Welfare, there are ongoing efforts, in line with the Nigerian Health Sector Renewal Investment Program to reform the country’s healthcare system.
He said the focus was on enhancing routine immunisation and reducing the number of zero-dose children through collaboration with state governments, including traditional leaders, as a key step towards improving overall population health outcomes.
“We will work as one team to strengthen governance, boost transparency and accountability, and address fiscal decentralisation as warranted by Nigeria’s federal system. Most importantly, we will deliberately enlist the active involvement of our citizens in decision-making and implementation processes to ensure that the healthcare system is reflective of and responsive to the needs of the population,” he said in a statement on Nigeria’s partnership with Gavi, the Vaccine Alliance team.
HPV
In 2023, the first dose (HPV1) programme coverage among girls was 27 per cent and the last dose (HPVc) programme coverage was 27 per cent.
Dropout rates
In 2023, 11 per cent of children who received DTP1 did not receive DTP3, and 14 per cent of children who received DTP1 did not receive MCV1.
The high DTP drop-out rates imply poor ability to provide a complete series of vaccines early in life, according to the report. The high DTP-MCV drop-out rates imply poor retention in immunization programmes and the ability to provide a full course of vaccines in infancy (up to one year).
In 2023, Nigeria’s DTP drop-out was higher and DTP-MCV drop-out was higher than global drop-out rates, respectively. In 2023, MCV2 had the lowest coverage at 38 percent, followed by ROTAC at 49 percent.
Compared to 2019, coverage of six vaccines decreased and 2 vaccines increased. Compared to 2022, coverage of eight vaccines remained constant and one vaccine increased.
Globally, the report shows that more than half of unvaccinated children live in the 31 countries with fragile, conflict-affected and vulnerable settings, where children are especially vulnerable to preventable diseases because of disruptions and lack of access to security, nutrition, and health services.
Additionally, 6.5 million children did not complete their third dose of the DTP vaccine, which is necessary to achieve disease protection in infancy and early childhood.
These trends, which show that global immunisation coverage has remained largely unchanged since 2022 and has not returned to 2019 levels, reflect ongoing challenges with disruptions in healthcare services, logistical challenges, vaccine hesitancy, and inequities in access to services.
