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Four million Nigerian children miss out in vaccination against measles

• Sokoto, Jigawa, Kaduna, Kano, Katsina, Borno, Gombe, Bauchi, Adamawa, Yobe, Zamfara, Kebbi, Bayelsa make list of 18 poor performing states

By Chioma Obinna

A healthy child is a pride of his or her parents and, in turn, guarantees a better future for the country. But, today, many Nigerian children do not live to celebrate their fifth birthday due to non-vaccination against preventable diseases. According to experts, Routine Immunisation, RI, remains one of the greatest and most cost-effective investments any country can use to protect, safeguard the future of its children and give them a chance to live healthy and productive lives. Meanwhile, millions of Nigerian children miss out of this cheap but life -saving vaccines. While the World Health Organisation, WHO, recommends a threshold of 95 per cent immunisation coverage to achieve ‘herd immunity’, according to the 2016/2017 Multiple Indicator Cluster Survey/National Immunisation Coverage Survey report, Nigeria’s National Routine Immunisation coverage stood at 33 per cent. Although a recent report by the National Emergency RI Coordination Centre, NERICC, showed a substantial improvement in RI performance, the country still ranks among countries with poor immunisation coverage. Sunday Vanguard reports:

vaccination against measles
Four million Nigerian children miss out in vaccination against measles

Complications

“I am afraid to lose him. His temperature in the last one week has been unimaginable”, 37-year-old Mrs Suliat Suleiman said amidst tears.

Two-year-old Ahmed had spent three days in one of the public hospitals in Lagos where he was confirmed to have measles.

Although he was old enough to have the first dose of measles vaccines, he was never given.

He was one of the over 29 percent of children whose vaccination cards were seen but not fully immunised.

According to medical experts, measles is a highly infectious viral illness that can result in a serious health complication.

Ahmed suffered some of these complications at home before he was rushed to hospital after the mother was done with self-medicating.

He had high temperature for weeks before rashes covered his whole body. Children like Ahmed with weak immune systems are at risk of measles complications.

Measles, which is one out of the diseases covered by routine immunisation, can cause complications such as diarrhoea and vomiting, leading to dehydration, middle ear infection, which lead to earache, eye infection and inflammation of the voice box.   In rare cases, experts say, it can lead to serious eye disorders, such as an infection of the optic nerve and nervous system problems, a fatal brain complication, which can occur several years after measles.   It occurs in one in every 25,000 cases.

In Nigeria alone, a report by UNICEF to mark this year’s World Immunisation Week showed that four million children missed out of the first dose of measles vaccines in 2017 and the country had the highest number of children under one year of age who missed out on the first dose of measles followed by India with 2.9 million, Pakistan, Indonesia (1.2 million each) and Ethiopia (1.1 million).

To reverse the situation, UNICEF Executive Director, Henrietta Fore, said, “If we are serious about averting the spread of this dangerous but preventable disease, we need to vaccinate every child in rich and poor countries alike.”

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As far back as 1990, Nigeria had achieved universal children immunisation coverage of 81.5 percent.

But since then, the country has witnessed a gradual but consistent reduction in immunisation coverage.

According to the World Health Organisation, WHO, vaccines have been one of the biggest success stories of modern medicine and it is no longer news that millions of deaths have been prevented due to vaccinations delivered around the world.

Many lives have also been protected from disability associated diseases such as pneumonia, diarrhoea, whooping cough, measles and polio.

Successful immunisation programmes also enable national priorities like education and economic development to take hold.

Although the country made great strides in reducing deaths of under 5-year-old children from 158 to 120 per 1000 births between 2011 and 2016, according to UNICEF,   in the same period, the coverage of the main vaccines offered through routine immunization continued to decline.

The 2016/2017 MICS report showed that only one in four children in the country receive all the recommended vaccines and over 36 percent of these children live in urban areas while only 14 percent are found in the rural areas.

The South-West has the highest number of children fully vaccinated with over 47 percent (47.9) while the South-South followed with over 38 percent, the South-East 36. 5 percent and the North-Central 26.2 Percent, the North-East has 17. 5 percent and the North-West have only 7.9 percent. It further showed that immunization coverage for pentavalent vaccine in the 36 states varies dramatically from 80 percent in Lagos to three percent in Sokoto and is still below the recommended global goal of 90 percent in all of them.

But experts say with proper immunisation and vaccination coverage, Ahmed and millions of Nigerian children will be saved from vaccine-preventable diseases including whooping cough, measles, German measles (rubella), meningococcal C pneumococcal disease, chickenpox, tetanus, mumps, polio, diphtheria, rotavirus and hepatitis.

Today in Nigeria, experts have identified several challenges facing routine immunisation in the country.   According to them, illiteracy, ignorance or low awareness on immunisation, misconception, inadequate refrigerators or cold chains equipment, shortage of vaccines and immunisation supplies, religion, political influence and negative attitude of health workers have contributed to the poor immunisation coverage in Nigeria.

For instance, in 2003, some parts of the country boycotted immunisation following rumours that polio vaccines can cause infertility.

According to the Executive Director, National Primary Healthcare Development Agency, Faisal Shuaib, the majority of states with low immunisation coverage are located in the North and the main causes of poor immunisation in the region include lack of awareness/knowledge of caregivers on immunisation-related issues, mistrust or fear, insecurity in some areas, attitude of health workers, inadequate commitment and ownership by some of the leaders, especially at the sub-national level.

Shuaib said the National Emergency RI Coordination Centre, NERICC, team had prioritised 18 poor performing states for implementation of strategic interventions.

“Since the establishment of NERICC, there has been increased nation-wide immunization coverage and, by March 2019, the figure stood at 54 percent, based on the 2018 Standardized Monitoring and Assessment of Relief and Transitions (SMART) survey report”, he said.

“The programme aims to reach at least 84 percent immunization coverage by 2028 through sustained implementation of the current NERICC’s strategic interventions”.

The Executive Director listed the 18 states as Sokoto, Jigawa, Kaduna, Kano, Katsina, Borno, Gombe, Bauchi, Adamawa, Yobe, Zamfara, Kebbi, Kogi, Taraba, Nasarawa, Niger, Bayelsa and Plateau states.

NERICC’s strategic interventions are focused towards surpassing Nigeria’s Strategy for Immunization and Primary Healthcare System Strengthening (NSIPSS) projected average of 84 percent coverage in 2028,” added.

A Private Sector Champion for Immunization in Africa by Gavi, Awele Elumelu, during the celebration of Africa Immunisation Week under the theme: ‘Protect together: Vaccines Work’ in Abuja, said immunisation yields healthy dividends for countries.

“The efforts to achieve widespread immunisation coverage cannot happen without the effective collaboration of the public and private sectors. This is why partnerships with public health organisations such as the NPHCDA matter”, he said.

Elumelu disclosed that since inception in 2000, GAVI has been able to immunise just over 300 million in Nigeria and prevent about 10 million deaths. “We still have up to about over four million unimmunised children so there is still a lot to be done.”

TIPS on vaccination:

Experts say vaccination is a very safe prevention tool. However, no medication can ever be 100% safe. The benefits of vaccination far outweigh the risks of becoming ill with a life-threatening disease.

Any concerns about vaccine safety should be raised with your doctor or immunisation provider.

Your child should not be vaccinated if they have a fever over 38.50C on the day of vaccination.

Like all medications, vaccines may have side effects. Nearly all of these are minor reactions, such as soreness at the injection site or a mild fever.   Most side-effects are short-lived and do not lead to any long term problems.

About 1 in 17,000 babies may develop intussusception in the first few weeks after the 1st and 2nd vaccine doses following rotavirus vaccination.

It is important to keep a record of your child’s vaccinations.   Proof of vaccination is often needed to enrol your child in childcare or school in some countries of the world.

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