Bridging Immunity Gaps: Nigeria’s Fight Against Poliovirus in High-Risk Communities
In the Jere Local Government Area (LGA) in Borno State, Amina*, four-year-old from Mairi Ward, a settlement in Buladina, has been intermittently immunized since birth. Despite multiple vaccination measures, she missed several recommended doses that left her vulnerable to polio virus infection.
Her mother, Saratu Bulama* (*name changed for privacy), said: “Amina missed some doses because we are not usually nearby when they are doing the vaccination exercise.”
Amina’s story reflects ongoing challenges in Nigeria in stopping the spread of polio virus and other preventable vaccine diseases, especially in difficult-to-reach and conflict-affected areas.
Treatment of Type 2 circulating variant poliovirus (CVPV2)
Stopping the spread of the cyclic variant poliovirus type 2 (CVPV2) remains a national priority in Nigeria. Despite vaccination for every child under five years of age, CVPV2 transmission remains. Between January 2024 and March 10, 2025, Nigeria reported 122 CVPV2 cases in 15 states, including 10 cases in 2025 alone.
The National Major Healthcare Development Agency (NPHCDA), in coordination with the National Emergency Operations Center (NEOC), has adopted a targeted local outbreak response (TLR) strategy to address the immune gap and curb the differences in the virus. The strategy focuses on high-risk areas designed to inoculate all susceptible children and disrupt transmission.
The latest four-day vaccination campaign targets 3.8 million children in seven high-deficiency states: Borno, Gigava, Kano, Kebi, Sokoto, Yube and Zamfara. By the end of the campaign, more than 3.6 million children received the new oral polio vaccine type 2 (NOPV2). However, there are still challenges – some children have been missed due to caregivers’ non-compliance or absence during vaccination.
NEOC Event Manager Dr. Abdulkadir Usman Gana acknowledged these gaps: “While seeing a large number of children arrive, we must strengthen social mobilization and refine our strategies to address vaccine hesitation and missed children. Our goal is to ensure that our efforts to disrupt CVPV2 transmission are not missing any children.
Targeted interventions to maximize impact
The NEOC operational task force by WHO plays a crucial role in planning and monitoring TLR activities. The team used a data-driven approach, triangular surveillance data, routine immune recordings, and polio laboratory results to define the range of each response. Plan parameters include analysis of CVPV2 isolates in LGA, timing of the latest situation, population immunity levels (via household surveys), risk status of adjacent LGA and wards, target population estimates, vaccine availability and logistical needs.
Dr. Walter Kazadi Mulombo, the representative of the Nigerian state, praised the TLR method as a rapid response mechanism that can curb the polio virus. “The TLR’s target nature allows for better oversight and high-quality execution,” he said. “We have a crucial opportunity to turn the trend with CVPV2, and it’s time to take decisive action. We remain committed to supporting Nigeria despite funding restrictions.”
Mobilize the community to achieve success
From planning to execution, who supports the implementation status of the entire activity. This includes training more than 18,727 health workers, facilitating coordination meetings before and after daily vaccination activities, and developing tracking systems to ensure compliance with immunization programs in target areas. They deployed over 6,000 personnel at national, state, LGA and ward levels to support the planning and implementation.
“We support coordination and oversight of the vaccination team, including logistics payments,” said Dr. Yusuf Muhammad Argungu, State Coordinator of Sokoto State. “They also promote advocacy and communication activities through our extensive network of people across LGA and wards.”
Community engagement is key. “I organized community conversations with the ward focus person to sensitize residents to the importance of vaccines. During the campaign, I worked with the rural chief to resolve cases of non-compliance and child absences, which increased our success rate in the wards.”
Measuring impact through quality assurance
To verify vaccination coverage data, they support states in conducting batch quality assurance surveys (LQAS). Independent professionals, including physicians and university lecturers, were deployed to randomly selected wards and settlements. Surveyors visited 10 random families in each area to verify the vaccination status of randomly selected children in the target age group.
The results of LQA are promising: 97% of the surveyed LGAs achieved more than 90% of vaccination coverage, indicating that most regions have strong campaign performance.
Looking to the future: Continuous efforts to end CVPV2
Nigeria is planning another TLR phase, targeting 946,600 children in five states starting March 12, 2025: Gigava, Oyo, Sokoto, Yube and Zamfara. These efforts aim to further bridge the immunity gap and maintain progress against CVPV2.
While challenges such as vaccine hesitation and logistical obstacles remain, collaboration between NPHCDA, NEOC, NEOC and local communities demonstrates Nigeria’s commitment to protecting every child from polio virus. With continuous innovation, community trust and global support, Nigeria is heading towards a polio-free future.
Distributed by Apo Group on behalf of the World Health Organization (WHO) – Nigeria.
