Ibrahim Mustafa, the Permanent Secretary of the Lagos State Primary Health Care Board (LSPHCB), has stated that around five percent of the state's health expenditure is channeled towards vaccination efforts, either directly or indirectly.
Speaking with the News Agency of Nigeria (NAN) on Sunday, coinciding with World Immunisation Week, Mr. Mustafa highlighted that routine immunisation within Lagos receives funding through a combination of federal vaccine supplies and state investments in critical areas like logistics, cold chain infrastructure, and service provision.
He further noted that these vital interventions are bolstered by the National Primary Health Care Development Agency, alongside contributions from international organisations such as the World Health Organisation (WHO), UNICEF, Gavi, the Vaccine Alliance, and AFENET.
Mr. Mustafa elaborated, "The state now commits a lot of resources to ensure that these vaccines get to the arms of the children. The Lagos State Government is one of the governments in the federation that is committing a lot to assist vaccination efforts."
He reported that routine immunisation coverage in Lagos has reached approximately 66 percent. However, he cautioned that several factors, including population mobility, vaccine hesitancy, and a significant number of children who have not received any vaccines (zero-dose children), continue to hinder complete community protection against preventable diseases.
These persistent challenges are largely attributed to the state's rapid population growth, fueled by migration from various parts of the country. Mr. Mustafa explained, "Many families arriving in Lagos, the country’s commercial hub, do so with children who have not completed or even started their vaccination schedules. That contributes significantly to the gaps we are seeing."
A child is classified as zero-dose if they have not received any routine vaccinations, particularly missing the initial dose of the diphtheria, tetanus, and pertussis-containing vaccine (DTP1).
Nigeria faces the highest global burden of zero-dose children, with 2.1 million recorded in 2023, predominantly in the Northwest and Northeast regions. Within Lagos, the Alimosho Local Government Area alone has identified over 35,000 zero-dose children, the highest number in any single LGA nationwide.
Mr. Mustafa estimates that Lagos is home to between 120,000 and 130,000 zero- dose children, with the majority residing in underserved and difficult-to- access areas like Makoko, parts of Alimosho, and Ikorodu.
He stressed the danger posed by large unvaccinated populations, warning that it weakens herd immunity and increases the risk of outbreaks for diseases that were once under control.
"If you have many zero-dose children, herd immunity drops, and that can lead to the resurgence of vaccine-preventable diseases," he stated.
Despite these challenges, Mr. Mustafa affirmed that Lagos remains a leader in Nigeria's health sector, attracting migrants seeking better healthcare services, which paradoxically strains the system.
To address these immunisation gaps, the state has intensified its outreach programs, response activities for outbreaks, and targeted vaccination campaigns for underserved populations. Health workers have also been deployed to locate and vaccinate children who have been missed.
Furthermore, Lagos has made considerable strides in introducing newer vaccines, notably the Human Papillomavirus (HPV) vaccine, which helps prevent cervical cancer. Initially introduced for girls aged nine to 14, the programme encountered significant resistance due to misinformation and mistrust.
"At one point, vaccinators faced hostility, including physical attacks in parts of Ibeju-Lekki, prompting us to deploy security escorts," he recalled.
In response to vaccine hesitancy, the government launched an extensive public engagement strategy involving community and religious leaders, as well as media and social media advocacy.
Mr. Mustafa credited groups like the Christian Association of Nigeria and Muslim leaders in Lagos, along with public figures such as Aproko Doctor and Kate Henshaw, for their crucial roles in building trust and promoting vaccination messages.
This multi-pronged approach has proven effective, with approximately 1.5 million girls now having received the HPV vaccine, and acceptance has surged following the initial resistance.
"We moved from very serious hesitancy to strong demand. Now, in many cases, people are asking for the vaccine themselves," he reported.
He underscored the critical role of strong government support in sustaining vaccination efforts across the state. He cited the recent inclusion of the measles-rubella vaccine into routine immunisation schedules, which received significant backing and funding from Governor Babajide Sanwo-Olu and his wife, and other government officials, even exceeding initial budget allocations.
Mr. Mustafa emphasized that such commitment is indispensable as Lagos navigates its growing population and ongoing immunisation challenges.
"Closing these gaps requires continuous investment and collaboration. We are not relenting. Our goal is to ensure that every child in Lagos, regardless of where they live, has access to life-saving vaccines."
He reiterated that fortifying routine immunisation while actively reaching zero-dose populations is paramount to preventing future disease outbreaks and maintaining the state's advancements in child health.
World Immunisation Week, observed annually from April 23 to 30, is dedicated to promoting the protective power of immunisation for all age groups against vaccine-preventable diseases. The theme for this year is "For every generation, vaccines work."
The WHO notes that vaccines are among the most effective public health tools, having saved over 150 million lives in the past five decades through individuals choosing protection for themselves, their families, and their communities.
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