Nigeria must move beyond campaign-style vaccination towards routine protection, argues
PAT ONUKWULI
Nigeria’s routine immunisation story presents a troubling contradiction: vaccines remain available and services continue, yet too many children lack full protection. Between 2023 and 2025, DTP3 coverage held at roughly 62–63 per cent, below the 90 per cent national target, while measles coverage remained weak, particularly for the second dose. The system is functioning, but progress has stalled.
That matters because immunisation tests whether primary healthcare works. A dependable health system should prevent disease before families are forced into treatment. When a child is fully immunised, the system has acted early. When that child is missed, the consequences can include illness, maiming, hospital admission, lost household income and avoidable death.
“Prevention is better than cure” is more than a slogan. Treating complications of measles, meningitis, whooping cough, polio and other vaccine-preventable diseases costs more than preventing them. Vaccination protects family income, reduces pressure on hospitals and preserves childhood development.
The evidence shows that vaccine supply does not equal vaccine coverage. Trade records reviewed for this article show vaccine imports in 2025, including measles, yellow fever, polio and tetanus-diphtheria vaccines, as well as syringes supplied through UNICEF. Commodities were moving, but a vaccine delivered to a warehouse does not protect a child.
The real test is the last mile. A vaccine can reach a state store but fail to reach a remote community. A mother may travel to a primary health centre only to find the vaccination team unavailable. A child may receive a first dose but never return for the next. Coverage improves only when the system follows children through the full schedule.
This is where statistics become personal. Behind every percentage point lies a family deciding whether to spend money on transport, to miss work, to return after a wasted journey, or to trust what a health worker offers. Immunisation is therefore not only about national targets; it is about a mother holding a child at a clinic door, wondering whether the system will work for her that day.
Complete national coverage data for 2026 are not yet available, so the year cannot yet be assessed. However, the 2023–2025 record tells us enough: routine services continued, yet Nigeria did not advance sufficiently. Persistent underperformance should not become acceptable simply because it is familiar.
There is also the question of confidence in immunisation products. Recent petitions allege that some auto-disable immunisation syringes were substandard. NPHCDA has rejected those allegations, saying its procurement processes met required standards and that many vaccines supplied through UNICEF arrive with corresponding syringes.
Rebuttal is not resolution. NPHCDA should do the needful: investigate transparently, publish verifiable evidence and address legitimate concerns, rather than assume that reassurance alone will restore confidence.
Public trust also has a history. The Abdullahi v. Pfizer, Inc. matter, arising from the 1996 Kano meningitis drug trial, left enduring questions about consent, safety and accountability. The point is not to equate that episode with today’s allegations, but to recognise a danger: when institutions offer denial rather than demonstrable proof, old suspicions can find new life.
Counterfeit, falsified, unregistered or substandard medical devices can harm more than the patient directly affected. They can undermine confidence in an entire programme. A defective syringe may harm one child, but fear of unsafe products can discourage many parents from vaccinating. The choice is not between protecting reputation and protecting confidence; confidence is protected by enforcing standards.
The answer is neither sensationalism nor secrecy. Every product used in childhood immunisation should be traceable, certified and independently verifiable. When allegations arise, regulators should investigate promptly, publish findings clearly and withdraw defective products where necessary. When claims are unfounded, they should be disproved just as clearly. Transparency is not public relations; it is integral to a credible immunisation system.
Nigeria must also move beyond campaign-style vaccination towards routine protection. Children are born every day, not only during mobilisation weeks. Primary healthcare centres need reliable staffing, cold-chain systems, community outreach, accurate records and defaulter tracking. They must be accessible to mothers facing transport costs, insecurity or inflexible clinic hours. A vaccine may be free, but access is not free when reaching it costs money.
The 90 per cent national target should remain a genuine standard. If coverage remains around 62–63 per cent for years, repetition must not normalise failure. National figures should be broken down by state, local government, zero-dose status and completion rates. The question is not merely how many doses were supplied, but which children were missed, why, and when the system will return to them.
Nigeria need not choose between expanding coverage and enforcing quality. It must do both: ensure safe vaccines, safe syringes and safe delivery, while ensuring every eligible child completes the schedule. That is what strong primary healthcare should mean: prevention delivered consistently, safely and close to where people live. Protect the child early or pay far more when disease strikes.
Dr. Onukwuli is a legal scholar and public affairs analyst. patonukwuli2003@yahoo.co.uk