To bridge immunisation gaps created by the COVID-19 pandemic and ensure that no child dies from vaccine-preventable disease, Nigeria has been urged on sustained approaches to improve vaccination access and uptake, PATIENCE IVIE IHEJIRIKA writes.
Several studies have shown that vaccination against childhood diseases, is one of the most cost-effective public health interventions available.
However, millions of children still miss out on life-saving vaccination every year. This existing burden has worsened by the COVID-19 pandemic which created unprecedented disruption in health services.
According to the United Nations Children’s Fund (UNICEF), every year, vaccines save an estimated two to three million lives, but COVID-19 threatens to roll back decades of progress made in reducing preventable child deaths by hindering access to these life-saving services.
With the pandemic putting enormous pressure on already weak or overstretched health systems, the number of unvaccinated and under-vaccinated children is expected to increase, exacerbating existing inequities and putting the lives of many children at serious risk of disease or death, said UNICEF.
The children’s rights organisation estimates that more than 94 million children were at risk of missing measles vaccines because of paused measles campaigns in 26 countries due to efforts to control COVID-19 (as of November 2020), threatening to exacerbate ongoing measles outbreaks.
“Worldwide, cases of measles surged to nearly 870,000 in 2019, the highest number of reported cases in the past 23 years. And global measles deaths have climbed nearly 50 per cent since 2016, claiming an estimated 207,500 lives in 2019 alone,” UNICEF added.
In Nigeria, the Nigeria Centre for Disease Control (NCDC)’s Measles Situation Report recorded 9,316 confirmed cases of measles in 603 LGAs across 36 states and FCT with 55 deaths in 2020.
Breakdown of the report showed that Katsina State with 1,778 cases, Sokoto 1,233, Yobe 1,202, Zamfara 1,102, Adamawa 777, Kebbi 756 and Borno 677 accounted for 49.8 per cent of the 15,099 suspected cases reported.
According to the report, the age group 9 – 59 months accounted for 58.7 per cent of all confirmed cases. Up to 5,422 (58.3per cent) of the confirmed cases did not receive any dose of measles vaccination (“zero dose”).
Of the 223 LGAs with reported outbreaks in 2020, five LGAs across five states had an ongoing outbreak in December.
According to the National Immunisation Coverage Survey (MICS/NICS 2016/17), only 23 per cent of children aged 12-23 months received all routine immunisations in Nigeria
The survey showed that 31 per cent of children who received the first dose of pentavalent vaccine did not get all three doses and that 40 per cent of children did not receive any vaccines from the health system.
The poor state of immunisation and its effects on Nigerian children led to the declaration of a state of emergency on routine immunisation by the National Primary Health Care Development Agency (NPHCDA) in 2017.
However, the National Nutrition and Health Survey (NNHS) 2019, indicates an improvement, resulting in 67 per cent routine immunisation coverage.
Identifying lack of awareness as a major barrier to immunisation uptake in the country, UNICEF, in collaboration with the Federal Ministry of Information and Culture, recently organised a media dialogue on routine immunisation and COVID-19 vaccination in Yola, Adamawa State.
Speaking during the event, the World Health Organisation (WHO) state coordinator, Iyobosa Igbinovia, said immunisation is the best way to secure the future of children, adding that the vaccines are safe, effective, free and available at all government health centers.
He, however, stressed the need for sustained mobilisation of heads of households to allow their spouses to take their children to health facilities for routine immunisation.
He also called for continuous sensitisation of community members to adopt key household practices such as hand and respiratory hygiene, sanitation and adherence to COVID-19 precautionary measures such as frequent hand washing, wearing of face masks in public and avoiding large gatherings.
On polio, UNICEF’s communication for development (C4D) specialist, Mrs. Elizabeth Onitolo, cautioned against complacency to avoid a resurgence of the wild poliovirus (WPV).
Nigeria was declared wild poliovirus free by the World Health Organisation (WHO) in 2020, after celebrating three years without any case of WPV in 2019.
She cautioned that the certification does not mean that the risks are over, stressing that the success recorded was still fragile due to low immunisation coverage while emphasing the need to mobilise and motivate the people, especially those at the community level to accept vaccines and ensure that they practice environmental sanitation and personal hygiene.
“Environmental sanitation and personal hygiene practice is still very low in the communities, providing a possible grounds for outbreaks.
“Poliovirus transmits from person to person or from wastewater to person. Children are especially vulnerable because their immune system is weak.”
Onitolo also said that there was a need for the media to target mobilisation efforts to leaders including heads of households because of their significant role in influencing routine immunisation coverage.
“We need to act now to protect our children from getting the poliovirus, we need to maintain herd community. This means every child must complete routine immunisation so that the virus will not have a window to re-enter our communities,” she urged.
Meanwhile, as the world mark 2021 vaccination week, UNICEF, WHO and Gavi, the Vaccine Alliance have said that even though immunisation services have started to recover from disruptions caused by COVID-19, millions of children remain vulnerable to deadly diseases.
They highlighted the urgent need for a renewed global commitment to improve vaccination access and uptake.
World immunisation Week is celebrated in the last week of April every year. It aims to promote the use of vaccines to protect people of all ages against disease.
Re-emphasising the importance of childhood vaccination, director general of WHO, Dr Tedros Adhanom Ghebreyesus, says “If we are to avoid multiple outbreaks of life-threatening diseases like measles, yellow fever and diphtheria, we must ensure routine vaccination services are protected in every country in the world.”
“Even before the pandemic, there were worrying signs that we were beginning to lose ground in the fight against preventable child illness, with 20 million children already missing out on critical vaccinations,” said UNICEF executive director, Henrietta Fore.
“The pandemic has made a bad situation worse, causing millions of children to go unimmunised. Now that vaccines are at the forefront of everyone’s minds, we must sustain this energy to help every child catch up on their measles, polio and other vaccines. We have no time to waste. Lost ground means lost lives,” she added.
“Millions of children across the world are likely to miss out on basic vaccines as the current pandemic threatens to unravel two decades of progress in routine immunisation”, said CEO of Gavi, the Vaccine Alliance, Dr. Seth Berkley.
“To support the recovery from COVID-19 and to fight future pandemics, we will need to ensure routine immunisation is prioritised as we also focus on reaching children who do not receive any routine vaccines, or zero-dose children. To do this, we need to work together – across development agencies, governments and civil society – to ensure that no child is left behind”, he added.
However, the director general of the National Primary Healthcare Development Agency (NPHCDA), Dr. Faisal Shuaib, says Nigeria has made progress on vaccine supply chain including deploying about 2,963 Solar Direct Drives (SDD) to all states. “We have begun to see tangible results, surpassing historical trends as our coverage increased from 33 per cent in 2016 to over 70 per cent in 2019.
“Recall that in July 2017, we declared a state of public health concern on routine immunisation and established the National Emergency Routine Immunisation Coordination Centre (NERICC). Leveraging on our experience in polio eradication, we are having this significant progress of more than doubling routine immunisation coverage within three years,” he said.