Diphtheria: Closing Immunisation Gap

For many Nigerian children, a routine vaccine could mean the difference between life and death. Yet, thousands remain unprotected.

The Nigeria Centre for Disease Control and Prevention (NCDC) has reported 1,319 deaths from diphtheria between 2022 and early 2025, exposing critical gaps in immunisation coverage.

Diphtheria, a bacterial infection caused by Corynebacterium species, attacks the nose, throat, and sometimes the skin. It spreads through direct contact, airborne droplets from coughing or sneezing, or contaminated objects. While the disease is vaccine-preventable, recent outbreaks highlight Nigeria’s struggle to ensure sufficient immunisation for its most vulnerable populations.

Since 2022, Nigeria has recorded 42,642 suspected diphtheria cases across all 37 states and 350 local government areas. Among these, 25,812 cases (60.5%) were confirmed. Alarmingly, only 19.3 per cent of those infected had received full vaccination against the disease.

Children between the ages of one and 14 bear the brunt of this crisis, making up nearly 63 per cent of all confirmed cases. The northern states; Kano, Yobe, Katsina, Bauchi, Borno, Kaduna, and Jigawa account for 96.3 per cent of suspected cases. The low vaccination rates in these areas have created fertile ground for outbreaks, underscoring the urgent need for stronger immunisation efforts.

Nigeria’s childhood immunisation schedule includes three doses of the pentavalent vaccine administered at six, ten, and fourteen weeks of life. Yet, many children never receive these critical doses due to logistical barriers, vaccine hesitancy, and inadequate healthcare infrastructure.

In response to the outbreaks, the NCDC said has ramped up surveillance, case management, laboratory testing, and vaccination drives.

However, the centre said challenges persist, including low test positivity rates, reliance on clinical diagnoses rather than laboratory confirmation, and insufficient PCR testing resources.

Recognising the urgency, Médecins Sans Frontières (MSF), also known as Doctors Without Borders, has partnered with the Sokoto State Ministry of Health to conduct large-scale immunisation campaigns. These efforts target children under five with vaccines against measles, diphtheria, tetanus, hepatitis B, and other preventable diseases.

In the first phase of the campaign, 53,095 children across Sokoto were vaccinated, 63 per cent of whom had never received any vaccines before.

MSF also conducted a similar drive in Zamfara State, where they reached over 51,000 children. The results were immediate: measles cases at Gummi General Hospital dropped by 57 per cent between June and December 2024 compared to the previous year.

“Vaccines are essential for preventing and controlling outbreaks of infectious. We have already seen the impact of these efforts, but more needs to be done,“ said MSF Medical Coordinator in Nigeria, Dr. Deo Kabila.

One of the biggest challenges in vaccination campaigns is misinformation. Religious and community leaders are now being engaged to build trust and encourage participation. Door-to-door mobilisation and multiple vaccination sites have been established to reach as many children as possible.

Community leaders have been very supportive, granting us access to their communities,“ said MSF’s Health Promotion Manager for routine immunisation in rural areas, Juliet Umenge.

Despite ongoing efforts, the country sstill faces an uphill battle. The country’s overall immunisation coverage remains below international recommendations, with 6.2 million children missing all vaccines in the past five years, according to the 2021 Multiple Indicator Cluster Survey (MICS).

With diphtheria continuing to claim lives, relevant stakeholders have been urged on strengthening routine immunisation programmes, addressing vaccine hesitancy, and ensuring equitable distribution of vaccines as top priorities.