Nigeria's COVID-19 Vaccine Rollout: Where Are We Now?
Almost 2 years after the first confirmed coronavirus case in Nigeria, the return to normalcy still appears to be a far-off prospect. Vaccines remain our best defense against the pandemic, yet less than 2% of the country’s population has been fully vaccinated.
Eight months on from our initial thought piece on Nigeria’s COVID-19 vaccine rollout, this article aims to discuss key questions regarding the progress made so far amidst subsequent waves of the virus, emerging new variants, global vaccine supply issues, and increasing travel restrictions.
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Question #1: Did Nigeria reach its goal of vaccinating at least 40% of the population by the end of 2021?
As of December 07, Nigeria had administered 11.2 million doses of COVID vaccines, 3.8 million of which were second doses. With a population of roughly 200 million people, that is only enough to fully inoculate 1.9% of the country’s population. Clearly Nigeria is still far off from vaccinating 40% of its population by the end of the year, joining the ranks of the 45 other African countries that are projected to miss this year-end target. These stats reflect the low vaccination rates seen across the continent - according to the WHO, only 77 million people, or 6% of Africa’s population are fully vaccinated, with just 1 in 4 African health workers fully vaccinated.
Question #2: What phase of the NPHCDA’s National COVID-19 Vaccination Rollout Plan is Nigeria currently in?
On August 16 2021, the NPHCDA commenced the second phase of the COVID-19 Vaccination Rollout. The COVID-19 vaccine is being rolled out in four phases. The first phase prioritized health workers, supporting staff, frontline workers and first responders. Currently, the second phase will prioritize individuals that are 50 years and above, starting with those that are 60 years and above. The initiation of the second phase of the vaccine rollout came shortly after Nigeria received four million doses of the Moderna vaccine donated by the United States.
As part of the second phase of the COVID-19 vaccination program, the NPHCDA has adopted a “whole family approach” which combines the COVID-19 vaccine with other important primary healthcare services like routine childhood immunization, malnutrition and screening for non-communicable diseases. This family package plans to simultaneously tackle the COVID-19 pandemic as well as other disease outbreaks such as cholera and Lassa fever that are seeing a large number of cases across the country.
Question #3: How many COVID-19 vaccine doses has Nigeria received?
To date, Nigeria has received roughly 8.9 million doses of COVID-19 vaccines according to the WHO. 96% of these vaccines were shipped through COVAX, an international scheme that works with governments and vaccine manufacturers to ensure equitable access to COVID-19 vaccines for lower income countries. Through the COVAX scheme, high income countries subsidize the costs for lower income countries - supporting countries include the US, UK, Canada, Japan, Australia, New Zealand, the UAE, France, Germany, Italy, Spain, Sweden, and Portugal.
On March 02 2021, Nigeria received the first shipment of almost 4 million doses of the Oxford-AstraZeneca COVID-19 vaccine shipped through the COVAX scheme. Nigeria also received an additional 300,000 doses of the Oxford-AstraZeneca vaccine from telecom giant MTN shortly after on March 21.
On April 06, the Indian government delivered 100,000 doses of COVISHIELD vaccines to Nigeria. The COVISHIELD vaccine is a brand of the Oxford-AstraZeneca vaccine manufactured by the Serum Institute of India. On August 01, the US donated 4 million doses of the Moderna vaccine to Nigeria through the COVAX scheme. The last shipment of COVID-19 vaccines received by Nigeria to date was the 500,000 doses of the Oxford-AstraZeneca vaccine from the French government through COVAX on October 08.
Question #4: How has the Omicron variant and potential fourth wave impacted the COVID-19 Vaccine Rollout Plan in Nigeria?
On December 01 2021, Nigeria recorded its first cases of the Omicron variant - joining the growing number of countries across the globe with confirmed cases of the latest WHO variant of concern. In the wake of the Omicron variant, the Nigerian government has announced nationwide plans to administer booster doses of the COVID-19 vaccines to eligible Nigerians to provide greater protection against the virus.
To ramp up the response to the Omicron variant and the rise in cases, the WHO is currently supporting African countries to improve genomic surveillance to track the virus and detect other potential variants of concern. As part of this initiative, the WHO is collaborating with the ACEGID lab to push forward these efforts in Nigeria.
However, despite these efforts and the widespread global presence of Omicron, more than 70 countries have imposed travel bans on southern African countries - some of which are yet to report Omicron cases. Some countries have extended these travel bans to include Nigeria - both Canada and the UK have imposed travel bans on Nigeria despite having a higher number of confirmed Omicron cases.
The WHO Regional Director for Africa, the Nigerian High Commissioner to the UK and the Nigerian Senate have condemned these travel restrictions and called for science-based public health measures to curb the spread of COVID-19. Several leading experts have highlighted the unequal distribution of vaccines globally as a major barrier to achieving widespread immunity to the virus and facilitating the emergence and explosive spread of new variants - ultimately, countries with the least access to vaccines will suffer the most as a result.
Several high income countries have supported the COVAX scheme, including those that have imposed travel bans on Nigeria and other African countries. However, there have been significant delays in COVAX’s ability to ship vaccines to the countries most in need as a result of export bans and the prioritization of bilateral deals between manufacturers and these high income countries.
Even after securing enough COVID-19 vaccines, several African countries have either discarded or returned thousands of doses. While vaccine wastage is expected in any immunization program and several countries across Europe have forecasted over 10% wastage of their vaccine supply, the trends observed in some African countries is cause for concern.
Reuters reported that 1 million doses of the AstraZeneca vaccine delivered through COVAX had expired in Nigeria in November - one of the largest single losses during the pandemic. While the official number of expired vaccines has not yet been confirmed by the Nigerian government, Dr. Osagie Ehanire, the Minister of Health, confirmed that the expired vaccines had been withdrawn from the rollout and will be destroyed by the National Agency for Food and Drug Administration and Control (NAFDAC), Nigeria’s agency responsible for drug and food standards.
Countries such as Malawi, South Sudan and the Democratic Republic of Congo have also destroyed or returned vaccine doses due to an inability to administer all the vaccines before their expiry date. While some countries report receiving the vaccines weeks before their expiry date, making it impossible to administer all doses on time, other countries cited weak infrastructure, public reluctance to get vaccinated and lack of preparedness as significant barriers to administering all of their vaccine supply.
Key Takeaways from TC Health: As the Omicron variant continues to spread rapidly, end-of-year travel and festivities push on and low vaccination rates remain commonplace, the COVID-19 vaccination rollout is becoming increasingly important to curb the spread of the virus in Nigeria and the African continent. Global multilateral cooperation between government, public health decision-makers and vaccine manufacturers is required to facilitate:
Genomic surveillance and scientific information sharing, particularly for new variants of concern
Increased vaccine production and supply
Implementation of science-based public health measures and travel guidance, instead of unilateral travel bans, to curb the spread of COVID-19
