COVID-19 Vaccine Distribution and Administration in Nigeria: Challenges and Moving Forward
With a population of over 201,000,000 and being the most heavily populated nation in Africa, Nigeria has only received less than 2% of all COVID-19 vaccines worldwide. Next to South Africa, Nigeria is the second-worst hit country in Africa and only one million eligible Nigerian citizens have received the first dose of the vaccine, equating to less than 1% of the total population.
As of right now, the Oxford/AstraZeneca vaccine is the only one available to eligible citizens.
The Nigerian government has already received 4 million vaccines from the global initiative
COVAX (COVID-19 Vaccines Global Access) and plans to obtain a total of 16 million vaccines.
There were also donations of 300,000 doses of the AstraZeneca vaccine from the
telecommunications company MTN and 100,000 doses from the Indian government. Currently, there have been no reported severe adverse side effects of the AstraZeneca vaccine among the one million Nigerians who have received it.
Nigeria’s National Primary Health Care Development Agency (NPHCDA) is responsible for vaccine distribution and is in its first phase of a four phase rollout, starting with the vaccination of individuals 18 years of age and older on the frontline in healthcare, as well as government officials, and contract tracing and rapid response teams. The process is being carried out through an e-registration system on the NPHCDA’s website where individuals pre-register online and obtain a vaccination ID. When they receive the first dose, their information is electronically stored through the primary health care agency in order to keep track of the administration of the second dose, which comes around 8-12 week after the first one.
The online registration system set in place, while efficient, poses significant accessibility
problems for half of the Nigerian population living in remote and rural areas who do not have access to internet connection. In addition, there is little to no information on how the
government is identifying and prioritizing Nigeria’s most vulnerable populations. These
difficulties will ultimately contribute to vaccine administration inequity.
On top of these obstacles are the challenges that arise from Nigeria’s weak public health system and overburdened health care networks. Healthcare is significantly underfunded to begin with and half of the licensed doctors in the nation are on strike due to poor working conditions and insufficient pay, with rural, poor, and remote areas bearing the weight of this. Given the existing fragile healthcare infrastructure, inequities, and other vulnerabilities and challenges, it is unclear how the government’s distribution plan will actually play out, given that their target is to vaccinate 70% of the population by 2022.
As of April 7th, the government has ordered states to halt the administration of first-doses of the AstraZeneca vaccine once half of their stock is depleted in order to safeguard supplies for the second doses. However, there is hope, as Nigeria is expecting another 40 million doses of the AstraZeneca vaccine to come in from the African Union (AU) by the end of April, and another expected 70 million doses of the Johnson & Johnson vaccine by the end of the year. The inclusion of the Johnson & Johnson vaccine is expected to be more efficient and accessible, as it is only administered in one shot, however there are rising concerns about the vaccine after the United States halted its administration following the development of rare blood clots in six women within two weeks of receiving the shot. Further investigation and research needs to be conducted in order to definitely draw a conclusion about the relationship between the Johnson & Johnson vaccine and blood clots.
While Nigeria has not received the Johnson & Johnson vaccine yet, there are fears that the
small number of rare and dangerous side effects, six out of 6.8 million treated with that
vaccination, will exacerbate the existing hesitancy of COVID-19 vaccines among the Nigerian
population, in part caused by low health literacy, insufficient education about the vaccine, and distrust around its source and production.
There have been consistent efforts on the part of organizations and government officials in
spreading accurate information and encouraging individuals to trust science and get vaccinated. The United Nations Children’s Fund (UNICEF) is motivating people to get the vaccine, relaying that the Johnson & Johnson vaccine is certified safe by the World Health Organization (WHO) and is a critical piece in public health and safety and preventing the spread of the virus. While Nigeria has not yet completed the transaction with Johnson & Johnson, Professor Oyewale Tomori, Chairmen on the Experts Review Committee of COVID-19 further pushes to provide accurate information to the public and expresses the benefits of the vaccine will outweigh the potential risks, as well as the importance of reporting any and all adverse side effects. President of the Pharmaceutical Society of Nigeria (PSN) Mazi Sam Ohuabunwa emphasizes caution, and like Tomori, recognizes the pros of vaccinations and assures that Nigerian health authorities will thoroughly review scientific investigations of the Johnson & Johnson vaccine before administering it to the public.