Abuja, In Nigeria, an estimated 6.2 million children missed out on receiving a single dose of their routine vaccines from 2019 to 2022 due to the COVID-19 pandemic.

To reach these eligible children with life-saving vaccines, the government of Nigeria, through the National Primary Healthcare Development Agency (NPHCDA), in collaboration with the World Health Organization (WHO) and its partners, including Gavi, the Vaccine Alliance is intensifying various strategies to optimize “Big Catch-up campaign” to improve vaccination coverage across the country.

Speaking at the recently concluded stakeholders' immunization meeting tagged –“Engagement with states on optimized outreach strategy,” in Abuja, the Executive Secretary NPHCDA, Dr Faisal Shuaib expressed optimism that with the trajectory, Nigeria has the willpower to cover 80% of the targeted zero-dose population by 2028.

The goal is to reduce the number of zero-dose children in Nigeria by 15% by 2024, and 80% by the end of 2028 (the 2018 strategic document for 10 years).

Dr Shuaib states that the workshop is important to strategize and adopt mechanisms that will ensure zero-dose and under-vaccinated children in Nigeria are being vaccinated. 

He explains that with the caregivers having little or no understanding of the importance of taking their children to health facilities for vaccination, it has become crucial for the government to devise mechanisms to ensure no child is left behind.

“The meeting is critical for us to achieve the immunization target goal. The leadership from the national and states level have together  agree that there is a need for a paradigm shift in the way we get vaccines to children. 

The workshop is to devise strategies to take vaccines to where the people live, especially to reach the children in the most difficult areas,” he says. 

Dr Shuaib buttresses that some of the mechanisms to be adopted include: improving the leadership, building the capacity of the leaders, increasing monitoring routine immunization sessions and supervision, and improving accountability and integration of health activities to ensure encompassing health services. 

Mapped out task 
Participants of the meeting include all state immunization principals from the 36 and Federal Capital Territory (FCT), officials of WHO and other international partners involved in implementing immunization programmes in the country.  

The two-day workshop is part of WHO support to the government to improve vaccination coverage as part of the commemoration of the 2023 Africa Vaccination Week awareness campaign.

Figures from the 2021 Multiple Indicator Cluster Survey (MICS) show that immunization coverage in Nigeria is still low. Data shows that at least 6.2 million children have never received or missed all their vaccines in the past five years. 

Similarly, a 2012 WHO and UNICEF estimates shows that Nigeria accounts for 2.2 million zero-dose children and is one of the six countries that account for half of all zero-dose children globally. 

The Big-Catch-up 
The WHO Cluster lead for Vaccine-Preventable Disease and Polio Eradication, Dr Kofi Boateng, says the WHO is working with the government on how to change the narrative of covering Zero-dose children and missed children. 

Dr Boateng explains that Zero-dose and missed vaccination are the reasons why the country is witnessing an increase in vaccine-preventable outbreaks like measles, diphtheria, and yellow fever among others. 
He says the workshop is part of the commemoration of the African vaccination celebration, which is riding on the theme, the big catch-up .

“The Big Catch-up provides the greatest opportunity to bring Nigeria back on track on achieving the targets for the Immunization Agenda 2030.  This meeting is to support Nigeria to prepare to catch up with about 6.2 million children that did not receive any vaccine from 2019 to 2021.  

We are reviewing the strategies that the states are going to adopt to make sure that all health facilities intensify their outreach sessions so that we can catch up on these numbers of children that are not immunized, he explains. 

To achieve this goal, WHO is supporting development of the strategies, guidelines and shaping resource optimization  as well as and monitoring activities at all levels particularly in the States, LGAs and Wards. WHO will also guide the quality and delivery of  training health workers, monitor the process and assess the quality of services from the planned intensified outreaches as against expected results. results. 

Furthermore, WHO has issued guidelines to enable all children less than 5years who missed routine immunization doses access vaccines appropriately. 

Building the momentum 
Building the momentum for the big catch-up, the Executive Secretary, Zamfara State Primary Healthcare Development Agency, Dr Tukur Ismail, says his state is up to the task of ensuring all eligible zero-dose children and those with uncomplete doses are covered.

He states that the state has been conducting routine Immunization activities and outreaches to catch up and data are already showing improvement. 

“We are going to use this optimized outreach strategy to ensure that we prioritize areas that we identified as having zero doses and unimmunized children and security-challenged areas to improve the outcomes, he says. 

He notes that the state government will be working with community mobilizers, and traditional and religious leaders to raise awareness about the importance of vaccines and the military in security-compromised areas to conduct hit-and-run immunization exercises. 

Agreeing with his counterpart, the Executive Secretary, of FCT Primary Healthcare Development Agency Isah Yahaya Vatsa, says talking about zero-dose in Nigeria is not good for the country. 

With the leadership at the NPHCDA, states, WHO and partners, we believe zero-dose can be addressed. It is the right of our children to be immunized and also the right of the mothers to access vaccination. 

We are working with the community and traditional leaders, as well as women groups, to ensure newcomers in the village with eligible children, especially in the Internally Displaced Person Camps (IDPs) are followed up for their children to be vaccinated.  

He says the FCT administration conducts routine immunization and periodic immunization outreaches.

Technical Contacts:
Dr Kofi Boateng; Email: boatengko [at] who.int (boatengko[at]who[dot]int)
Dr Richard Koko; Email: kokor [at] who.int (kokor[at]who[dot]int)