Executive Director, National Primary Health Care Development Agency (NPHDA), Dr. Faisal Shuaibin this interview of SADE OGUNTOLAtalks about COVID-19 vaccination coverage, COVID-19 milestones, and challenges in increasing vaccination.
WHAT are some indicators that COVID-19 is not over in Nigeria?
In the last week, 25 new confirmed cases of COVID-19 have been reported in the country. There is also a report of an increase in the number of COVID-19 cases in China, the United States of America, the United Kingdom, among other countries. The Federal Government of Nigeria is focused on ensuring that the eligible population is fully vaccinated with COVID-19 vaccines to achieve the herd immunity necessary for protection against the disease. Vaccines remain the most cost-effective public health tool against vaccine-preventable diseases.
At the last COVID-19 Strategy Team meeting, an update on underperforming states on vaccination was provided. What states are these and what were their limitations?
The country’s goal is to vaccinate at least 70 percent of the eligible population with the COVID-19 vaccine. As of January 20, 2023, Nigeria has fully vaccinated 65,143,040 (56%) eligible people with the vaccine; while 76,957,026 (66.4%) of eligible people have taken at least one dose of the vaccine.
Thirteen states have achieved 70 percent and more complete vaccination of their eligible population. These include: Nasarawa, Jigawa, Kaduna, Osun, Kano, Adamawa, Gombe, Plateau, Kwara, Ekiti, Sokoto, Kebbi and Yobe states. Seven states (Zamfara, Imo, Oyo, Borno, Niger, Enugu, Bauchi) plus the Federal Capital Territory (FCT) have achieved coverage between 40 and 70 percent. The remaining 16 low performing states with less than 40 percent coverage include: Katsina, Cross River, Ogun, Abia, Anambra, Benue, Edo, Lagos, Taraba, Akwa Ibom, Delta, Ebonyi, Bayelsa, Kogi, Rivers and Ondo. The bottom seven states have less than 20 percent full vaccination coverage.
The main current challenge associated with the low coverage in some of the states is the “unfelt need” for vaccination against COVID-19 among citizens. Other challenges include vaccine hesitancy due to misinformation and misinformation about COVID-19 vaccines; and insecurity throughout the country, which prevents health workers from providing health care services, including vaccination.
What are the specific challenges fueling low COVID-19 vaccination coverage in your agency’s experience?
The biggest challenge early in the introduction of COVID-19 was the global shortage and inequity in access to COVID-19 vaccines. This has since been overcome as we now have enough COVID-19 vaccines in the country to cover the eligible population.
Other specific additional challenges observed in the low performing states such as Lagos, Akwa Ibom, Rivers and Kogi were the suspension of the vaccination exercise for approximately two months due to some technical challenges; but these challenges have already been addressed. The agency, in collaboration with other partners, is providing technical support to these very low-performing states and improvement is expected in the coming weeks.
Based on the latest COVID-19 vaccination update for Nigeria, how has the implementation of Ladder 3.0 further helped in increasing vaccination coverage?
Several indigenous and innovative strategies for the vaccination exercise against COVID-19 have been implemented in the country since March 5, 2020. From phases 1 and 2 and SCALES 1.0 where the TEACH strategy was used to the SCALES 2.0 strategy and now SCALES 3.0. Yes, it is true that the SCALES 3.0 COVID-19 vaccination strategy has further helped in increasing COVID-19 vaccination coverage in the country.
A total of 25,963,167 people were fully vaccinated during the Phase 1, Phase 2 and SCALE 1.0 vaccination exercise; and an additional 35,794,075 people were fully vaccinated during SCALES 2.0 which lasted 674 days. As of January 20, 2023, an additional 47,839,574 people have been fully vaccinated with COVID-19 vaccines during the SCALES 3.0 vaccination that has so far lasted just 163 days. There has been an improvement from 26% with all vaccines at the end of SCALES 2.0 vaccination to 56.2% with all vaccines during SCALES 3.0 vaccination (as of today, January 20, 2023).
In other words, just by implementing the SCALES 3.0 strategy, about 30% of additional eligible people were fully vaccinated within five and a half months. This is a huge improvement and achievement compared to what the country has achieved before and what has been done in many other African countries.
Ebola, Lassa fever, and even COVID-19 have made people more aware of the need to prepare for epidemics. Are there any other vaccines, interventions, or strategies Nigerians should be aware of and adopt to be better prepared for any epidemic that may occur in Nigeria?
There are vaccines and interventions that Nigerians need to be aware of and adopt in order to be better prepared for any epidemic that may occur in the future in the country. For example, the COVID-19 vaccine is currently available for the ongoing COVID-19 pandemic. There are also routine immunization shots available for children under one year of age to prevent vaccine-preventable diseases. All the vaccines used for immunization programs in the country are very safe and effective.
Families, businesses, healthcare facilities, and government organizations can prepare for disasters and different types of public health emergencies. The CDC has updated the pre-pandemic planning guidelines for community mitigation strategies that can be used to plan and prepare for an influenza pandemic and other emergencies.
The pandemic has provided an opportunity to strengthen the health system by taking advantage of the resources available for the response to COVID-19. That is currently the county’s policy direction. The agency is currently advocating for this policy through ongoing integrated COVID-19 vaccination with routine immunization and other primary health care services.
As part of the Federal Government’s effort to ensure the country is well prepared for the future pandemic, President Muhammadu Buhari recently announced that Nigeria was ready to become a global hub for the sustainable manufacturing and distribution of vaccines and other biologic pharmaceuticals after of the country being selected along with five other African countries by the WHO and the European Union (EU) during the last EU-Africa Summit in Brussels, Belgium, for mRNA technology transfer and the Global Training Center for Biomanufacturing of vaccines on the African continent. These efforts, among many others, are steps in the right direction to prepare the country and the African continent for the future pandemic.
Can you give an update on the number of children who have received doses since rotavirus vaccination was stopped?
The Nineteen (19) Northern Countries Rotavirus Vaccine Introduction Phase One (1) Launch was held in the Federal Capital Territory (FCT) on August 22, 2022; and the launch of the introduction of phase two (2) in the seventeen (17) southern states took place in Edo State on November 21, 2022.
As of December 31, 2022, the rotavirus vaccine has been administered to a total of 5,221,807 children nationwide. So far, a total of 4,062,288 children from the 19 northern states have been vaccinated, and the remaining 1,159,519 children are from the 17 southern states starting in November 2022.
The federal government through the NPHCDA has provided a waiver for 16 and 17 year olds to receive COVID-19 if necessary for educational purposes. So can you give an idea of how many Nigerians in the age range have benefited from vaccination?
A total of 2,299,395 children between the ages of 16 and 17 have been given COVID-19 vaccines since its inception in 2020, as an exemption for that age group for educational purposes.
Can you detail some of Nigeria’s COVID-19 vaccination milestones?
From the outset, the country aimed to reach 70% of its eligible population with COVID-19 vaccines by the end of December 2022. By December 31, 2022, 67.6% of the eligible population (75,585 197 people) had received the first dose of the COVID-19 vaccines; and 56.4 percent were fully vaccinated. This is an incredible achievement compared to what other African countries have been able to achieve in the same period. Vaccination against COVID-19 has been integrated with routine immunization and other APS services. Vaccination data against COVID-19 are captured on the Electronic Immunization Data Management (EMID) platform; and is now being expanded to include routine immunization services.
The APS Traditional Leaders Committee was also inaugurated in the South-East and South-West zones in addition to the existing Northern traditional committee in APS. The process of setting up the traditional South-South committee is at an advanced stage.
What is the NPHCDA currently doing to address the rise in diphtheria cases across the country?
The agency is working with the Kano State team and other stakeholders to address the ongoing diphtheria outbreak in the state. Specific priority actions taken thus far by the agency include following collaboration with NCDC and other stakeholders to conduct case investigations in LGA/affected states, as well as providing technical support in collaboration with other stakeholders for the conducting an integrated COVID -19 and routine immunization in Kano, Lagos and other high-risk states to address the ongoing diphtheria outbreak in these states.
The agency plans to conduct a mass vaccination campaign in the population identified as at risk for diphtheria in high-risk states with prevalent vaccine and other routine immunization antigens. There is also ongoing public awareness and sensitization for parents and carers to bring their eligible children for routine immunization at the nearest health center or vaccination site. In addition, treatment of confirmed cases of diphtheria with appropriate antibiotics is also ongoing in the affected states.