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Nigeria and burden of unvaccinated children

By Maria Famakinwa

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In a new report, “The State of the World’s Children 2023,” that should worry health authorities in the country, the United Nations Children Emergency Fund (UNICEF) has revealed that 2.2 million children in Nigeria have never received a vaccine. The United Nations agency found that 67 million children across the world missed out on either some or all routine vaccinations between 2019 and 2021.

Not surprisingly, half of the total number of unvaccinated children are in Africa. More disturbing is that out of the number of children at the risk of death and vaccine-preventable diseases, Nigeria is second, only to India with 2.7 million children. 

According to the report, prominent among the factors responsible for interrupted childhood vaccination across the world was the Covid-19 pandemic. UNICEF said that the intensive demands on health systems, the diversions of immunisation resources, health worker shortages and stay-at-home measures all contributed to missed vaccinations. These are in addition to conflicts, climate change and vaccine hesitancy.

However, the challenge was more on our continent where the public perception of the importance of vaccines declined and further exacerbated the persistent weaknesses in health systems and primary healthcare.

“We cannot allow confidence in routine immunisations to become another victim of the pandemic. Otherwise, the next wave of deaths could be of more children with measles, diphtheria, or other preventable diseases,” UNICEF Executive Director, Catherine Russell warned. 

Speaking at this year’s World Immunisation week, UNICEF’s Health Specialist, Dr. Ijeoma Agbo, who described the figure of 2.2 million unvaccinated children in Nigeria as alarming noted that some people are quite aware of immunisation but lack the knowledge about the age children are supposed to receive it. “Some don’t understand the importance of it and even when you speak to some caregivers, they don’t even know how to go about it and where to get it from.  So, we have seen that knowledge and awareness is still a major problem.

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She said, “We are still seeing these pockets of unvaccinated children, despite all the efforts that have been made. We have unvaccinated children that account for about 2.2 million in Nigeria and particularly in certain states like Lagos and Kano, just based on our population. Another problem that we have seen is in terms of access. Poverty is a big problem that we know is still rampant in Nigeria. For some, even the finance to access the health facilities where they will get these vaccines is still a huge problem, especially in our hard-to-reach areas, conflict areas. That has been a major issue in terms of accessing these immunisation services”.

Vaccines are among the greatest advances in global health and development. For over two centuries, they’ve safely reduced the scourge of diseases like polio, measles and smallpox, helping children grow up happy and healthy.  Despite these longstanding benefits, factors like violent conflicts, displacement, COVID-19-related disruptions, and vaccine misinformation have cut children off from routine immunizations. Some 25 million children are now missing out on life-saving vaccines every year, placing them at risk of preventable diseases like measles and pertussis. The poorest and most marginalized children, often most in need of vaccines – continue to be the least likely to get them.

Speaking with The Hope, a nursing mother, Mrs Modupe Ademipo, revealed that some nursing mothers don’t like vaccinating their children, due to inadequate knowledge of the benefits of vaccination. The woman who also blamed social media for the problem said: “Misleading information on the social media against children’s vaccinations discouraged some parents. Even though we were educated about the many benefits of vaccinating our children during antenatal meetings, some still refused to adhere because of what they read on the social media.”

A teacher and nursing mother, Mrs. Joy Agbasi, disclosed that some nursing mothers often argued that their children would be fine with or without vaccinations and confusing others that the risks of being vaccinated outweigh its benefits. She said: “A young mother in my area also shared this belief until her baby fell sick and she rushed the baby to the hospital. She regretted her failure to vaccinate her baby because she spent more when the baby was admitted which would have been avoided if she had vaccinated him. I think that health providers should do more sensitisation, especially to people in the interior.

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“Every nursing mother should understand that immunization is a measure used to track progress towards lowering child morbidity and mortality. It is one of the most cost-effective public health initiatives. It is thus essential that the health authorities in Nigeria must do more to ensure that all children are immunised and protected. Government at all levels, as well as other critical stakeholders, must act now to “catch up” with those missed vaccinations to prevent more deadly disease outbreaks. More importantly, there is an urgent need to intensify education and awareness of the deadly consequences of avoiding child vaccinations. Prevention, which is the whole idea of vaccination, as the old saying goes, is better than cure.”

A retired nurse, Mrs. Afolakemi Aduni, blamed religious beliefs of some parents for refusing to vaccinate their children. The woman disclosed that some nursing mothers who argued against vaccination believed that children could survive without it. She said: “Religious reasons tend to account for the majority of total vaccine refusal, while parents with personal beliefs against immunization tend to be more willing to compromise, and at least partially vaccinate their children. What can health providers do if parents fail to embrace vaccination for their children’s well-being?

“The only way out is for the religious leaders to partner with the government, especially at the local level, and educate their followers on the importance of vaccination. Otherwise, the number of unvaccinated children may increase. There is a need for parents to be more educated about many benefits of vaccination for children’s safety. I have heard a case of some nursing mothers living in rural areas discouraging others from vaccinating their children. Some would argue that mad women who gave birth never vaccinated their children, yet they survived. Unknown to them, such children are special and government is responsible for their up-keep. I wonder why a sane mother can be comparing herself with a mad woman. Government should do more in educating religious leaders, including traditional rulers, on the importance of vaccinating the children, so that they can pass the message to their followers. Doing this will help to reduce the number of unvaccinated children in the country,” she advised.

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In the contribution of Dr (Mrs.) Omowumi Afolabi, Senior Registrar in Community Health Department, Federal Medical Centre (FMC), Owo. She explained that children are more susceptible to infectious diseases due to their developing immune systems which is the reason they must be vaccinated.

Dr. Afolabi, who appealed to nursing mothers to prioritize the health of their children stressed that the importance of vaccinating the children cannot be overemphasized. She said: “Vaccines protect children from serious illnesses like measles, mumps, rubella and whooping cough, among others. Vaccination helps protect them from severe outcomes, including hospitalization and death. It helps create herd immunity, which reduces the overall prevalence of diseases in the community.

“Besides, vaccinating our children helps prevent outbreaks of vaccine-preventable diseases in schools, daycare centres, and communities, helping to maintain a safe and healthy environment for children to learn and grow. Vaccines provide long-term protection against diseases, helping children stay healthy throughout their lives and reducing the burden of preventable illnesses on healthcare systems. Vaccinating children is crucial for global health efforts, contributing to the control and eradication of diseases worldwide, ultimately saving lives and improving the well-being of communities globally,” she said.

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