Diphtheria: Why Every Child Deserves Immunisation

For many Nigerian children, a routine vaccine can mean the difference between life and death. Yet, thousands remain unprotected, as diphtheria, a preventable bacterial infection, continues to spread across the country.

According to the Nigeria Centre for Disease Control and Prevention (NCDC), from epidemiological week 19 of 2022 to week 18 of 2025,  43,743 suspected diphtheria cases across 360 Local Government Areas in 37 states were recorded.

The burden remains heavily concentrated in the North as six states; Kano (24,415), Yobe (5,330), Katsina (4,355), Bauchi (3,066), Borno (3,064), and Kaduna (840) accounted for 96 per cent of reported cases.

Out of the total suspected cases, 26,499 (60.6%) were confirmed, with 423 laboratory-confirmed, 255 epidemiologically linked, and 25,821 clinically compatible. The disease has claimed 1,376 lives, translating to a 5.2 per cent case fatality rate, the report stated.

According to NCDC, over 63 per cent of confirmed cases (16,687) were among children aged one to 14. Alarmingly, only 4,999 (19.1%) of them had been fully vaccinated with a diphtheria toxoid-containing vaccine.

Diphtheria, caused by the Corynebacterium bacteria, affects the throat, nose, and sometimes the skin. It spreads easily through coughs, sneezes, and contact with contaminated objects. Though vaccine-preventable, the current outbreak has exposed glaring gaps in Nigeria’s routine immunisation system.

Nigeria’s national immunisation schedule recommends three doses of the pentavalent vaccine at 6, 10, and 14 weeks. But systemic challenges such as limited access to healthcare, vaccine hesitancy, misinformation, and infrastructure deficits, mean many children miss these lifesaving doses.

In response, the NCDC says it has intensified surveillance, case management, testing, and vaccination efforts. Yet, the agency acknowledges persistent hurdles, including overreliance on clinical diagnosis, low lab confirmation rates, and a shortage of PCR testing kits.

To support containment, Médecins Sans Frontières (MSF) partnered with the Sokoto State Ministry of Health for a large-scale vaccination drive targeting children under five. In the first phase, 53,095 children were vaccinated, 63 percent  of whom had never received a vaccine.

MSF also launched a similar campaign in Zamfara, vaccinating over 51,000 children. The impact was immediate: measles cases at Gummi General Hospital dropped by 57 per cent between June and December 2024 compared to the same period the previous year.

“Vaccines are essential for preventing and controlling outbreaks. We have already seen their impact, but more needs to be done,” said Dr. Deo Kabila, MSF’s Medical Coordinator in Nigeria.

Misinformation remains a major barrier to vaccine uptake. To combat this, MSF and other health agencies are engaging religious and traditional leaders to promote trust. They’ve also launched door-to-door campaigns and established multiple outreach sites to reach underserved communities.

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

Meanwhile, following a recent diphtheria outbreak in parts of Edo State, which has claimed at least two lives, the Edo State Government said it has  activated an emergency public health response.

In a statement issued by the Chief Press Secretary to the Governor, Fred Itua, the government said all necessary resources and expertise have been deployed to contain the disease and protect residents.

“Government wishes to inform the general public that it is fully aware of the recent outbreak of diphtheria reported in certain parts of the state. In response, the administration of Governor Monday Okpebholo has activated an emergency public health response,” the statement read.

The state government had on June 9 dispatched 70 doses of anti-diphtheria vaccines to the University of Benin Teaching Hospital (UBTH), where two patients reportedly died of the disease.

According to the government, hospitals across Edo have been placed on high alert and directed to intensify case detection, isolation, and clinical management in line with national and international health protocols. Medical personnel are also being equipped and briefed to provide prompt responses to emerging cases.

The government has also expanded its disease surveillance network to facilitate rapid contact tracing and case reporting. Additionally, the Honourable Commissioner for Health, Dr. Cyril Oshiomhole, is leading the medical response and providing regular updates to the public.

Despite ongoing efforts, the challenge remains immense. According to the 2021 Multiple Indicator Cluster Survey (MICS), over 6.2 million Nigerian children have missed all routine vaccines in the past five years.

With diphtheria continuing to claim lives, public health experts have called for urgent investment in routine immunisation, better health education, and stronger vaccine supply chains.