Maryam Abbas (not real name) vowed not to take her two-month-old son for another shot of immunisation because he became very ill after the first dose of the pentalent vaccine. Even though Abbas said she was not sure if it was the vaccine that caused the illness, she did not want to risk it.
Like Mariam, who is a resident of Bauchi local government area in Bauchi State, many women default in taking their children for vaccination due to persisting misconceptions or poor awareness of its importance, the Bauchi State primary health care development agency (BASPHCDA) said.
In addition, the United Nations Children’s Fund (UNICEF) notes that COVID-19 disruptions, increasing inequalities in access to vaccines, and the diversion of resources from routine immunisation are leaving too many children under the age of five without protection against preventable diseases.
Rilwanu Mohammed, executive chairman of BASPHCDA, told BusinessDay during a field trip to Bauchi that one of the biggest challenges facing the state is low uptake of routine immunisation.
“We have only 39 percent of routine immunisation coverage. A significant number of mothers still do not know the importance of vaccination, some of them started but later dropped out, that’s the biggest challenge we are having,” Mohammed said.
A child needs multiple doses for full protection from life-threatening diseases such as measles, polio, pneumonia diphtheria, pertussis, tetanus, hepatitis B, haemophilus influenza type B, among others. Studies show that adverse reactions that follow immunisation can also fuel hesitancy if not managed properly.
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Despite the availability of vaccines, Nigeria tops countries in the world in terms of the number of zero-dose children, i.e. children who never received any single dose of vaccine since they were born, and the country still accounts for 30 percent of the global number of unimmunised children between the ages of zero and five.
According to the Nigeria Demographic and Health Survey (NDHS) 2018, one out of five children did not receive any basic vaccination, and only 31 percent of children aged 12 to 23 months received all basic vaccinations.
As a consequence, no fewer than 3,000 children die every day of preventable diseases. Nigeria overtook India to become the world’s highest contributor to under-five deaths after recording an average of 858,000 deaths in 2019 out of 5.2 million under-five deaths globally, according to UNICEF. This is in addition to the huge economic loss the country suffers.
The COVID-19 pandemic widened the immunisation gap further; at least 23 million children missed out on basic childhood vaccines through routine health services, the highest number since 2009 globally.
If urgent action is not taken to close the immunisation gaps, it will become outbreaks leaving millions of children exposed, experts warn. They also note that measles outbreak is drawing attention to the need for greater attention to immunisation.
Nearly 60 percent of children that missed out on measles vaccination in 2020 were from just 10 countries, including Nigeria. Studies have shown that measles is the most contagious vaccine-preventable disease, and an outbreak of it is a sign that outbreaks of other diseases may occur.
Nigeria also risks a resurgence of wild polio after being declared free, due to low immunisation and other prevailing factors. The country is already reporting a spike in the transmission of vaccine-derived poliovirus type 2 (cVDPV2).
Prior to the wild poliovirus free declaration, the country reported one case in 2016, no case in 2017. In 2018 and 2019, 34 and 18 cases were reported respectively. In 2020 eight cases were reported, then 397 cases in 2021, and in March 2022, the number cases spiked to 1,060 across 29 states and the nation’s capital.
More so, the African region has recorded an outbreak of the virus, after many years since the last case was recorded. Malawi announced its re-emergence in February 2022, while Mozambique reported a case in March.
The National Primary Healthcare Development Agency (NPHCDA) stated that polio does not respect borders or boundaries; hence every child below five years must be protected.
Also, according to BASPHCDA, the declaration of Nigeria polio-free in August 2020 has made more mothers even more reluctant, believing that the virus is gone forever.
During a field trip to some primary healthcare centres in Bauchi, it was found that some babies are not administered Oral Polio Vaccines (OPV) at birth.
In Tashan Babiye primary healthcare centre in Bauchi LGA for instance, records show that of the 98 children born from January to March 2022, 36 children did not receive the OPV vaccine. In Dawaki community, more than 170 children born were not administered the first dose of the vaccine within the same period.
Similarly, in Dott community in Dass LGA, 13 children out of 76 births recorded in the primary health care facility were not vaccinated against the virus at birth. It took Nigeria decades to finally eradicate polio and $298 million was expended by donors, while the Federal Government said it spent N9.8 billion between 2016 and 2019 only.
Oyewale Tomori, a professor of virology, warned that a case of an eradicated disease should not be only a cause for concern, but most importantly, a call for action to ensure that it does not exceed reported cases.
Tomori, in a chat with BusinessDay also expressed concern that the surge in cVDPV2 in the country, low immunisation and poor sanitation in communities are factors that can lead to a resurgence of the virus in Nigeria with children being the most vulnerable group.
