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By Ogechi Obi. DLHA Volunteer and Freelance writer, with medical review and editorial support by the DLHA Team.
Vaccination is an effective way of keeping the community healthy. Each year, childhood vaccines save up to four million lives worldwide and it is estimated to prevent more than 50 million deaths between 2021 to 2030.(1)
Routine immunisation is the process by which countries provide access to lifesaving vaccines for the control and eradication of vaccine-preventable diseases.
This process involves the regular and timely vaccination of children and adults in a country with vaccines that are considered important for the prevention and reduction of diseases that cause the most disabilities and deaths.
Routine immunisation in Nigeria is organized and implemented by the country’s health managers under a set of national public health vision, management objectives and goals (the Nigeria National Programme of Immunisation) that are aimed at the
The essential components of Nigeria's routine immunisation align with and promote the broader context of the country’s health and social welfare systems.
Nigeria's National Programme on Immunisation aligns with the Expanded Programme on Immunisation (EPI) that was established in 1974 by the World Health Organization (WHO) as a global process to strengthen universal immunisation exercises.
The WHO's EPI strategies has improved vaccine coverage across all countries but with varying success.
According to a 2021 study, global immunisation coverage has dropped to its lowest rate in recent times, with most children in Africa receiving zero doses of basic vaccines in the same period. (1)
The EPI was introduced in Nigeria in 1978 (2) with a name change to the National Programme on Immunisation in 1996. The aim of the programme is to provide immunisation to children below the age of two years. The programme has recorded intermittent success so far.
A 2016/2017 National Immunization Coverage Survey in Nigeria showed that only 1 in 4 children received all recommended vaccines. Nearly 1 in 3 was partially vaccinated and 1 in 2.5 received no immunization whatsoever. (3)
The reasons identified (3) for why most Nigerian children are not fully vaccinated include:
Vaccines are cost-effective and prevent disease occurrence and worsening of common communicable diseases.
Routine immunisation protects not only the child but can extend protection to all children in the community.
This article will walk you through some essential information you need to know about vaccines and routine immunisation.
According to the US Centers for Disease Control and Prevention, vaccines are preparations that are used to stimulate the body’s immunity against harmful agents. (4)
Vaccines could be the weakened, fractured, or killed forms of germs (micro-organisms).
A vaccine can also be a biological preparation of proteins that is part of an infectious organism or toxins/by-product that is no longer active.
Biological toxins (chemicals) from germ (microbial) agents can be inactivated to produce a vaccine that would stimulate the immune system. Like in the case of tetanus, pertussis, and diphtheria vaccines.
Inactivated vaccines are not as strong as live or weakened vaccines and may require several doses to produce an effective response.
The use of messenger RNA technology has made it possible to produce vaccines (e.g. some COVID-19 vaccines) that would instruct the human cells to make proteins found on the surface of the virus and display them on cell surfaces to stimulate the immune system to release antibodies against the virus.
In this type of vaccine, the risk of accidental infection by the virus does not occur because the vaccine contains no trace of the virus.
Some common vaccines are listed in Table 1 by their categories.
Table 1: Listing of vaccine types by categories. Click on the image to enlarge.
When vaccines are administered to the body, they stimulate the body’s immune system to release antibodies (B-cells) that would fight against the agent of the vaccine.
Although the organisms, proteins, or toxins used in making vaccines are not active and cannot cause diseases, they are still able to trigger the immune system to produce “weapons” that protect the body.
In other words, a child vaccinated with the measles vaccine would develop immunity against the measles virus such that if and when the child is exposed to the virus, the child would not be infected.
Immunisation and vaccination are similar and both provide protection and immunity against infectious diseases.
According to the US Centers for Disease Control and Prevention, Immunization is “a process by which a person becomes protected against a disease through vaccination” and Vaccination is “the act of introducing a vaccine into the body to produce protection from a specific disease”. (4)
The term immunisation is often used interchangeably with vaccination or inoculation.
However, immunisation has a broader meaning as it explains various processes of protecting the body against diseases.
Immunisation can be either active or passive.
Active immunisation occurs when an individual’s immune system is stimulated naturally or with vaccines to produce B-lymphocytes (special types of white cells) and antibodies.
In passive immunisation, an individual receives antibodies already produced in another individual.
Passive immunity can be from mother to child or from serum antibodies of animal or human donors previously infected with or vaccinated against the organism.
The protection provided by passive immunisation is immediate but it may only last for a short while.
On the other hand, active immunity takes time to develop, provides longer protection, and reactivates upon subsequent exposure to that infectious agent.
Every African child is eligible for vaccination from birth.
In a bid to reduce childhood disabilities and vaccine-preventable deaths, Nigeria has adopted several measures that include the creation of a routine immunisation schedule that is founded on WHO's Expanded Program of Immunisation (EPI).
The goal of this program is to ensure that every child is vaccinated against the six common killer diseases in the country. These include:
The expectation is that children between the ages of 12 to 23 months would be fully vaccinated following the immunisation schedule of the Nigerian Federal Ministry of Health.
The vaccines and vaccination schedule for children within their first year of life year in Nigeria is summarised in Table 2. (5)
According to the Nigerian Federal Ministry of Health definition, as quoted by Ophori et al., (2) a child is considered fully vaccinated if he or she has received a BCG vaccination against tuberculosis; three doses of DPT to prevent diphtheria, pertussis (whooping cough), and tetanus; at least three doses of polio vaccine; and one dose of measles vaccine.
Table 2: Common childhood vaccines and their vaccination schedule in Nigeria. Adapted from the WHO. Click on the image to enlarge.
You can walk into a nearby hospital or health center in Nigeria and register your child for immunisation.
These vaccines are usually given by injections. But some may be administered orally or through nasal sprays.
The benefits and possible side effects of routine immunisations in Nigerian children are fully considered in a separate blog.
Vaccines are preparations that are used to stimulate the body’s immunity against harmful diseases.
Routine immunisation is the process through which countries provide life-saving vaccines to control and eradicate common vaccine-preventable diseases.
In adopting the World Health Organization’s Expanded Programme on Immunisation (EPI), Nigeria developed its own schedule of vaccination to target six childhood killer diseases for control and eradication.
The success of this programme so far has been limited. Among the two major factors that are responsible for this situation are low public awareness of the beneficial role of vaccination and service delivery issues.
The Nigerian government and other stakeholders in health need to work together in co-producing and implementing measurable and actionable steps to raise full childhood immunisation coverage in the country to at least 80% by the year 2030.
1. CDC: (2023 April 20). Fast Facts on Global Immunization. https://www.cdc.gov/globalhealth/immunization/data/fast-facts.html
2. Ophori EA, Tula MY, Azih AV, Okojie R, Ikpo PE. Current trends of immunization in Nigeria: prospect and challenges. Trop Med Health. 2014 Jun;42(2):67-75. doi: 10.2149/tmh.2013-13.
3. NCIS (2018): National Immunization Coverage Survey: https://www.jhsph.edu/ivac/wp-content/uploads/2018/04/Nigeria-NICS-National-Brief.pdf.
4. Centers for Disease Control and Prevention (CDC). Immunization: The basics. Last reviewed September 1, 2021. Available from: https://www.cdc.gov/vaccines/vac-gen/imz-basics.htm. Accessed July 15, 2023.
5. World Health Organization. Vaccination schedule for Nigeria, (n.d.). Available from: https://immunizationdata.who.int/pages/schedule-by-country/nga.html?DISEASECODE=&TARGETPOP_GENERAL=. Accessed July 19, 2023.
Published: July 24, 2023
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