The low rate of completion of Nigeria’s four-dose malaria vaccination schedule is slowing plans to expand the programme to more states, the National Primary Health Care Development Agency (NPHCDA) has said.
The federal government received its first batch of malaria vaccine doses in October 2024 and has deployed the vaccine in Kebbi, Bayelsa, Ondo and Bauchi states.
Muyi Aina, executive director and CEO of the agency said only between 20% and 30% of children who receive the first dose return for the fourth dose, which is required to obtain full protection.
He said the agency was prioritising measures to improve follow-up and ensure more children complete the vaccination schedule before extending the programme to additional states.
Speaking on Thursday at the quarterly briefing organised by the agency in Abuja, said the malaria vaccine was a new intervention that required a different approach to delivery because children must return to health facilities four times to complete the schedule.
He also described the malaria vaccine as the most expensive vaccine provided under the country’s immunisation programme, noting that the government was still assessing what it could afford to sustain in the long term.
“It’s the first vaccine that you have to return four times to the facility to take. It’s also by far the single most expensive vaccine that we have to provide,” he said.
“Of all the people that got the first dose, somewhere between 20% and 30% is the proportion that is coming back on the fourth dose. So we don’t want to waste it. Why give it to people if they’re not going to complete the schedule and get the full protection from it?
“So before we expand to more states, can we figure out how to maximise value from this vaccine? Let’s build systems around follow-up and retention in the programme that allows our citizens to come back for the fourth dose”, Aina added.
The DG warned against expanding the programme without first addressing the challenges preventing children from completing the vaccination schedule, arguing that doing so could undermine the value of the resources invested in the intervention.
He said the government needed to ensure that children who receive the first dose return for the remaining doses instead of committing additional resources to expanding the programme while a substantial proportion of recipients fail to complete the schedule.
Addressing the recent measles outbreak, the DG said 93 per cent of children affected by the outbreak had either not been vaccinated or had failed to complete their vaccination schedule.
As part of the response, the DG said the agency had supplied more than 1.5 million doses of a vaccine, as well as 2.6 million doses of tetanus-containing vaccines across states.
On primary healthcare, the DG reported increases in the utilisation of several primary healthcare services, including antenatal care, skilled birth attendance and immunisation.
He said first antenatal care attendance had increased from 1.6 million visits per quarter to 1.8 million visits per quarter.
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