The Impact of Integration: Vaccinating 100M+ Children in Nigeria
Nigeria is in the midst of its largest vaccination campaign to date, aiming to reach approximately 106 million children with life-saving vaccines in a phased approach. Led by the country's National Primary Health Care Development Agency, the campaign delivers vaccines protecting against measles, rubella, and poliovirus alongside other essential health services, including catch-up of routine immunizations, mass drug administration for neglected tropical diseases (NTDs), and seasonal malaria chemoprevention (SMC). This integrated approach streamlines service delivery to efficiently reach children across different age groups and in underserved communities, providing an opportunity to close long-standing immunization gaps and advance equity goals. The first phase of the campaign began in October 2025, reaching 59 million children across 21 states, while the second phase began this month in the country’s remaining 16 states. Financial support is being provided by Gavi, the Vaccine Alliance and the Gates Foundation, among other donors.
Campaign activities are being delivered through fixed sites, temporary outreach posts, and house-to-house teams to reach children in areas that may have been missed by past vaccination efforts. This strategy aims to increase vaccine uptake, particularly among zero-dose children, and to address existing immunization gaps that have led to persistent outbreaks of measles, diphtheria, and circulating variant poliovirus type 2 (cVDPV2).
Integrating multiple health interventions into a single campaign can increase efficiency and stretch limited resources. For example, the same vaccinators can be used to administer multiple vaccines to provide significant savings on personnel costs. An integrated approach can also reduce some of the campaign fatigue among vaccination teams and caregivers, who can become overwhelmed by multiple campaigns in a short time frame.
This campaign also represents the country’s introduction of the combined measles-rubella (MR) vaccine, rather than the standalone measles vaccine used in Nigeria in the past. As rubella infection can lead to congenital rubella syndrome (CRS) in newborns of infected mothers, the MR vaccine has significant health benefits now and in the future. “Nigeria’s phased introduction of the MR vaccine represents a major public health milestone, aiming to protect millions of children from rubella and prevent future cases of CRS,” explained Chizoba Wonodi, MBBS, DrPH, MPH, an Associate Scientist at the Johns Hopkins Bloomberg School of Public Health who is working with in-country partners to deliver technical assistance during the ongoing campaign, thanks to funding from the Gates Foundation. Dr. Wonodi and her team are also documenting lessons learned from this campaign to inform future vaccination efforts.
“This historic effort demonstrates Nigeria’s ability to mobilize the considerable logistical and technical know-how to vaccinate millions of children over a relatively short period of time,” said Dr. Wonodi. The campaign also illustrates the potential impact of integrating multiple health interventions and can serve as a blueprint for future immunization efforts, in Nigeria and beyond.
