COVID-19: Nigeria fails on vaccination target as bottlenecks persist

Nigeria has missed its target to vaccinate 40 percent of the eligible population, a situation that puts the country at risk of possible devastating waves of the COVID-19 pandemic or more severe variants, according to health experts.

Early this year, the government set a target to vaccinate 40 percent of the 111,776,503 eligible population, representing over 44 million Nigerians by the end of 2021. The target is critical for Nigeria to achieve herd immunity and possibly exit the pandemic and its consequences.

Faisal Shuaib, executive director, National Primary Health Care Development Agency (NPHCDA), in January said 70 percent of the total population would be vaccinated by the end of 2022, ahead of the vaccine rollout that began in March 2021.

Shuaib explained that 40 percent would be vaccinated in 2021, while the remaining 30 percent would be covered in 2022. But only 4 million have received their full dose of the vaccine while a little over 8 million have received at least one dose, nearly 10 months after vaccination began nationwide.

Already, the World Health Organisation (WHO) says Africa is experiencing a fourth wave, which is largely driven by the Omicron variant. Even though there is still limited evidence on the severity of this variant, WHO warns that Omicron is highly transmissible and should not be taken for granted.

Nigeria Centre for Disease Control (NCDC) has so far confirmed six cases of the latest Omicron variant, and the country is already witnessing a surge in cases. On December 15 alone, NCDC confirmed 1,424 new cases, the highest since the third wave eased, which brings the total confirmed cases to 220,020 and 2,983 fatalities.

Some health analysts say the current pace of vaccination is slow and could take Nigeria about a decade to vaccinate the entire adult population against COVID-19, if the country continues with the current pace.

Nigeria’s vaccination suffered slow rollout since March – but the country has already witnessed three waves of the virus, during which more deaths and surge in cases were reported. The vaccine hesitancy, sadly, comes at a time when vaccine passport has become critical for travels and countries are imposing travel restrictions on Nigeria and other African countries on the back of the Omicron variant.

Read also: Nigeria’s COVID-19 cases hit 9-month high

Despite awareness campaigns, the Nigerian government decries that citizens are not showing up for vaccination and are not observing the preventive protocols either. To deepen vaccination, the government created mass vaccination sites in public places and mandated federal workers to show proof of vaccination, but the number of persons vaccinated is insignificant compared to the targeted population.

Meanwhile, Nigeria has set another ambitious target to vaccinate 50 percent of the eligible population by January 2022, a plan experts believe would not be realised until Nigeria addresses bottlenecks bordering on vaccine hesitancy and logistics.

Patrick Dakum, CEO, Institute of Human Virology in Nigeria in an interview with BusinessDay, says the emergence of more transmissible or deadlier strains of the virus has a more devastating impact on populations with low vaccination. Some other analysts argue that low vaccination can cause the emergence of deadly variants.

Dakum says Nigeria needs to increase the pace of vaccination over 10 fold, saying, “If we don’t vaccinate over 70 percent, especially of all vulnerable groups, that is – all persons over age 50 and all those with underlying diseases. The events in Europe can happen in Nigeria if we allow a fourth wave of the pandemic, especially with constant emergence of more infectious strains.”

But Nigerians are still hesitant about taking the vaccines. The Sultan of Sokoto, Muhammadu Abubakar III, said during a meeting on COVID-19 with traditional rulers and the Federal Government that communities in the North still have mistrust for the vaccines, majorly due to ignorance.

“The government needs to convince us, because if we leave these meetings without trashing all the issues we won’t be able to tell our people or answer the questions they would ask us, because there are so many questions that need answers. Once there is no trust, you won’t have anything positive coming out of your actions. We need to discuss how to get people to trust this vaccine,” he said.

In the same vein, seven out of 10 Nigerians interviewed by BusinessDay in the Federal Capital Territory (FCT) said they cannot trust the vaccines – though two out of these seven have been vaccinated. Their reason for vaccine hesitancy, they say, comes from poor transparency on the side of the government and safety concerns.

“First, I don’t believe this virus is as severe in this country as our government is making us believe, they just want funds from donor agencies. Secondly, I have serious concerns for the quality of vaccines being administered in Nigeria; anything is possible in this country,” a taxi driver who identified himself as Patrick said.

“My name is Nkiruka Obi, I took the AstraZeneca vaccine because it is a requirement in my workplace, but I am not really comfortable. Moreover, the latest news that some of the vaccines donated to this country have expired or about to expire gives me a lot of concern because I don’t know if I have fallen victim to the expired one. For me, I won’t want my family to take it”

Adaobi Onyechi, a health expert, also knocks the government for poor transparency with the vaccination so far, particularly on the expired vaccines exposed by a foreign media, and the government forced to disclose the issue. She says such actions are likely to further discourage citizens from taking the vaccines.

Onyechi notes that while Nigeria’s progress on vaccination is very low, the emergence of variants of concern with possibility of escaping immunity poses a threat.

“Also, I am concerned about Northern Nigeria where insurgency persists. I am concerned about the impact of this on the vaccination campaign. Most of these 4 million Nigerians who have been vaccinated are elites and live in cities, what about our rural communities that are neck deep in insurgency,” she queries.

While there are still concerns around vaccine equality, Nigeria is not utilising all available doses, and the government is set to destroy up to 1 million doses of expired AstraZeneca.

Osagie Ehanire, minister of health, decries that donations received through COVAX often have short shelf lives and expire before usage in addition to logistic bottlenecks.

“Nigeria has, of late, enjoyed the generosity of several donors, mainly European countries, who have offered us doses of COVID-19 vaccines out of their stockpiles, free of charge, through COVAX or AVAT facility.

“However, some of them had residual shelf lives of only a few months that left us very short time, some just weeks, to use them, after deduction of time to transport, clear, distribute and deliver to users. If such vaccines arrive back-to-back or are many, logistic bottlenecks occasionally arise,” the minister states.