Nigeria moves to tackle vaccine hesitancy, underreporting of adverse events
By Ojoma Akor
Nigeria has intensified efforts to strengthen vaccine safety surveillance and tackle vaccine hesitancy as experts warned that misinformation and underreporting of adverse events following immunization (AEFIs) could undermine the country’s vaccination programs.
The experts spoke in Abuja and fielded questions from reporters during the launch of the Nigeria Vaccine-Related Events (VRE) Response Plan, a national framework designed to improve the detection, reporting, investigation, and response to vaccine-related events.
Led by the National Primary Health Care Development Agency (NPHCDA) and African Field Epidemiology Network (AFENET), with support from partners including the U.S. Centers for Disease Control and Prevention (CDC) and others, the plan outlines the responsibilities of stakeholders involved in vaccine safety surveillance and response.
Dr Saheed Gidado, National Coordinator of the National Stop Transmission of Polio (NSTOP) program under AFENET, described the launch as a “watershed moment” for Nigeria’s immunization program.
According to him, the framework provides a coordinated mechanism for responding to vaccine-related events and is critical to rebuilding caregiver confidence.
“Vaccines protect millions of children in Nigeria, and for us to really optimize the uptake, it is important for us to build trust and build that confidence,” Gidado said.
He said the plan’s success would depend on active participation by all stakeholders, noting that the document clearly outlines the roles and responsibilities of government agencies and development partners.
Underreporting remains a challenge.
Gidado acknowledged that underreporting of AEFIs remained a major challenge, but said addressing the problem was one reason the new response plan was developed.
He said the framework would strengthen Nigeria’s ability to detect, report, and investigate AEFIs, while also addressing misinformation, disinformation, and rumors circulating through social media and other channels.
“With this plan that has articulated the roles and responsibilities of major stakeholders at the national and subnational levels, we will be able to really strengthen the country’s capacity to detect and, more importantly, report and investigate all AEFIs and other vaccine-related events,” he said.
He added that partners were expected to use their respective strengths to support implementation, including training health workers and providing accurate information to caregivers.
HPV, COVID-19 vaccines affected by rumors
Dr Lilian Okeke, Vaccine Safety Project Lead at AFENET, said strengthening public trust was a major objective of the new framework.
She said Nigeria had experienced vaccine distrust and rumors during the introduction of the human papillomavirus (HPV) vaccine and COVID-19 vaccines, including claims that vaccination could cause infertility.
Okeke said the VRE Response Plan would guide health workers and other stakeholders, including the media, on how to respond to vaccine misinformation and rumors.
“One of the issues that we found is distrust, people not believing in the vaccines that are delivered from the primary healthcare center,” she said.
She highlighted the media’s important role in responding appropriately when misinformation emerged in communities.
According to her, risk communication should be strengthened so that accurate information reaches caregivers quickly whenever rumors or concerns about vaccines arise.
She said vaccines were designed to protect people from diseases and urged stakeholders to communicate their benefits clearly to communities.
Parents and caregivers can report vaccine reactions.
Abdulazeez Yahaya, head of Surveillance at NPHCDA, explained that Nigeria had established a reporting structure extending from health facilities to local governments, states, and the national level.
He added that health workers alone were not responsible for reporting vaccine-related events.
“From the health facilities, the detection is not only the responsibility of health workers; caregivers and parents are also expected to report when there are AEFIs,” he said.
He explained that designated AEFI focal persons at health facilities, Local Government Disease Surveillance and Notification Officers, and State Disease Surveillance and Notification Officers formed part of the reporting pathway.
According to him, reports of AEFIs, including serious cases, are escalated to the National AEFI Technical Working Group, which reviews investigation reports before cases undergo expert causality assessment.
The findings are subsequently communicated back to subnational and facility levels.
He said the system would enable Nigeria to determine whether a vaccine actually caused an event or if it was coincidental.
The NPHCDA surveillance official also said Nigeria’s move toward local vaccine production made strengthening vaccine safety systems increasingly important.
He expressed optimism that Nigeria could begin producing vaccines locally in the coming years, making robust safety surveillance and regulatory systems essential to maintaining public confidence.
Not every reaction after vaccination is caused by vaccines
Dr Ahmed Muhammad Gusau, Zamfara State Epidemiologist and Chairman of the State Epidemiologists Forum, said the new plan was timely, particularly given the challenge of vaccine hesitancy and the continued circulation of vaccine-preventable diseases.
He said effective implementation would require cascading training to all 36 states and the Federal Capital Territory (FCT) and subsequently to local government areas.
“We are working on a plan to cascade the training at the subnational level, that is, to the 36 states, including FCT, and also to the various LGAs of the country,” Gusau said.
He said the training would help health workers and communities understand how to report vaccine-related events and ensure that feedback reached affected communities.
The epidemiologist also stressed the importance of distinguishing genuine vaccine reactions from events that merely occur after vaccination.
He explained that an event following vaccination could result from the vaccine itself, an immunization error, a defective product, a coincidental illness, or even anxiety associated with vaccination.
“For instance, somebody may have a fever from other origins, not related to the vaccine, but he will develop a fever after the vaccination. People will relate it to the vaccine,” he said.
He added that errors by vaccine administrators could also cause reactions that might be wrongly attributed to the vaccine.
“There is a need for a huge enlightenment,” Gusau said, stressing that better public understanding would improve acceptance of immunization.
They urged government agencies, development partners, health workers, communities, and the media to work together to detect vaccine safety concerns early, investigate them scientifically, and communicate transparently.
The ultimate objective, they said, was not only to identify genuine vaccine-related risks but also to prevent misinformation and unfounded rumors from eroding public confidence in vaccines that protect Nigerians from preventable diseases.