Executive Director, National Primary Healthcare Development Agency (NPHDA), Dr Faisal Shuaib, in this interview by SADE OGUNTOLA, speaks on COVID-19 vaccination coverage, milestones attained on COVID-19 and challenges to increasing vaccination.
WHAT are some indicators that COVID-19 is not over in Nigeria?
In the last one week, 25 confirmed new cases of COVID-19 have been reported in the country. There is also a report of a surge in the number of COVID-19 cases in China, United States of America, United Kingdom, among other countries. The Federal Government of Nigeria is focused on ensuring that the eligible population is fully vaccinated with the COVID-19 vaccines to achieve the necessary herd immunity for protection against the disease. Vaccines remain the most cost-effect public health tool against vaccine-preventable diseases.
At the last COVID-19 strategy team meeting, an update was given on low performing states on vaccination. Which states are these and what were their constraints?
The country’s target is to vaccinate at least 70 per cent of the eligible population with COVID-19 vaccine. As at 20th January, 2023, Nigeria has fully vaccinated 65,143,040 (56 per cent) eligible persons with the vaccine; while 76,957,026 (66.4 per cent) eligible persons have taken at least one dose of the vaccine.
Thirteen states have achieved the 70 per cent and above full 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 between 40 per cent and 70 per cent coverage. The remaining 16 low-performing states with less than 40 per cent coverage include: Katsina, Cross River, Ogun, Abia, Anambra, Benue, Edo, Lagos, Taraba, Akwa Ibom, Delta, Ebonyi, Bayelsa, Kogi, Rivers and Ondo states. The last seven states have less than 20 per cent full vaccination coverage.
The current major challenge associated with low coverage in some of the states is the ‘no felt need’ for the COVID-19 vaccination amongst the citizens. Other challenges include vaccine hesitancy because of the misinformation and disinformation about the COVID-19 vaccines; and the prevailing insecurity across the country, preventing health workers from providing health care services, including vaccination.
What are the specific challenges fueling low COVID-19 vaccination coverage based on your agency’s experience?
The major challenge at the beginning of the COVID-19 introduction was that of global scarcity and inequity in the access to the COVID-19 vaccines. This has since been overcome, as we now currently have enough COVID-19 vaccines in the country to cover the eligible population.
Other additional specific challenges observed in the low-performing states like Lagos, Akwa Ibom, Rivers and Kogi was the suspension in the vaccination exercise for about two months due to some technical challenges; but these challenges have now been addressed. The agency in collaboration with other partners is providing technical support to these very poor performing states and an improvement is being expected within the next few weeks.
Based on the latest COVID-19 vaccination update for Nigeria, how has scale 3.0 implementation further helped in the increase of the vaccination coverage?
Several indigenous and innovative strategies have been deployed for the COVID-19 vaccination exercise in the country since 5th March, 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 SCALES 3.0 COVID-19 vaccination strategy has further helped in the increase of the COVID-19 vaccination coverage in the country.
A total of 25,963,167 persons were fully vaccinated during the phase 1, phase 2 and SCALES 1.0 vaccination exercise; and additional 35,794,075persons were fully vaccinated during the SCALES 2.0 that lasted for 674 days. As at 20th January 2023, additional 47,839,574 persons have been fully vaccinated with COVID-19 vaccines during the SCALES 3.0 vaccination that have so far lasted for only 163 days. There has been an improvement from 26 per cent fully vaccinated at the end of SCALES 2.0 vaccination to 56.2 per cent fully vaccinated during the SCALES 3.0 vaccination (as at today 20th January, 2023).
In other words, with the SCALES 3.0 strategy implementation alone, about 30% additional eligible individuals were fully vaccinated within five and half months. This is a tremendous improvement and achievement if we compare this with what was previously achieved by the country and what has been done in many other African countries.
Ebola, Lassa fever and even COVID-19, all made people more aware of the need for epidemic preparedness. Are there other vaccines, intervention, or strategy that Nigerians need to know about and adopt to be better prepared for any epidemic that may occur in Nigeria?
There are vaccines and interventions that Nigerians need to know about and adopt to be better prepared for any epidemic that may occur in the future in the country. For instance, COVID-19 vaccine is currently available for the ongoing COVID-19 pandemic. There are also routine immunisation vaccines available for children under one year to prevent vaccine preventable diseases. All vaccines used for immunization programmes in the country are very safe and effective.
Families, businesses, healthcare facilities, and government organisations can prepare for disasters and different types of public health emergencies. CDC has updated pre-pandemic planning guidelines for community mitigation strategies that can be used to plan and prepare for a flu pandemic and other emergencies.
The pandemic has provided an opportunity to strengthen the health system leveraging on the available resources for COVID-19 response. That is currently the county’s policy direction. The agency is presently championing this policy through the ongoing integrated COVID-19 vaccination with routine immunisation and other PHC 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 sustainable manufacturing and distributions of vaccines and other biological pharmaceuticals after the country was selected alongside five other African countries by WHO and the European Union (EU) during the last EU-African Summit in Brussels, Belgium for mRNA technology transfer and Global Training Hub for Bio-manufacturing of vaccines on the African continent. These efforts, among many others, are steps in the right direction towards preparing the country and the African continent for the future pandemic.
Can you give an update on the number of children that have received doses since the flag off rotavirus vaccination?
Phase one (1) rotavirus vaccine introduction launch in the nineteen (19) northern took place at the Federal Capital Territory (FCT) on the 22nd August 2022; and the phase two (2) introduction launch in the seventeen (17) southern states took place in Edo State on 21st November 2022.
As of 31st December 2022, a total of 5,221,807 children across the country have been administered the rotavirus vaccine. A total of 4,062,288 children have so far been vaccinated from the 19 northern states, and the remaining 1,159,519 children are from the 17 southern states that started in November, 2022.
The Federal Government through NPHCDA has given a waiver for persons aged 16 and 17 to receive COVID-19 if required for education purposes. So can you give an idea of how many Nigerians in the age range have come out to benefit from the vaccination?
A total of 2,299,395 children 16 – 17 years have so far been administered COVID-19 vaccines since inception in 2020, as a waiver for that age group for educational purposes.
Can you itemize some of the COVID-19 vaccination milestones of Nigeria?
The country from the beginning targeted reaching 70 per cent of its eligible population with COVID-19 vaccines by the end of December 2022. By 31st of December 2022, 67.6 per cent of the eligible population (75,585,197 persons) was reached with the first dose of the COVID-19 vaccines; and 56.4 percent were fully vaccinated. This is an incredible achievement when compared with what other African countries have been able to achieve within the same period. COVID-19 vaccination has been integrated with routine immunisation and other PHC services. COVID-19 vaccination data is being captured on the Electronic Management of Immunization Data (EMID) platform; and now being expanded to capture routine immunisation services.
Traditional Leaders Committee of PHC has also been inaugurated in the South-East and South-West zones in addition to the existing northern traditional committee on PHC. The process for the inauguration of the South-South traditional committee is at an advanced stage.
What is NPHCDA currently doing to address the upsurge of 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 so far taken by the agency include the following collaboration with the NCDC and other stakeholders for the conduct of case investigation in the affected states/LGAs as well as provision of technical support in collaboration with other stakeholders for the conduct of an integrated COVID-19 and routine immunisation in Kano, Lagos and other high-risk states to address the ongoing diphtheria outbreak in these states.
The agency is planning to conduct a mass vaccination campaign in the identified population at risk for diphtheria in the high-risk states with prevalent vaccine and other routine immunisation antigens. There is also an ongoing awareness creation and sensitisation of the public for parents and caregivers to take their eligible children for routine immunisation at the nearest health facility or vaccination site. Also, treatment of confirmed diphtheria cases with appropriate antibiotics is also ongoing in the affected states.
