In Africa, one in five children do not receive all the necessary routine immunizations, causing 30 million children annually to experience vaccinepreventable illnesses. In part this is due to limited access, where several underreached communities, sometimes vulnerable to conflict or poverty, do not have vaccines available for their children. In Nigeria, over 2.1 million children are unvaccinated or zero-dose, the highest rate of unvaccinated children on the continent. Within Nigeria there is also sharp regional variation with immunization rates being significantly lower in the north compared to the south (full immunization coverage at 32.4% and 57.3% respectively).

A number of factors play a role in low vaccination rates across Africa, from cultural and socio-economic to environmental factors such as distance to the health facility, access to accurate information about vaccines and vaccine services, transportation availability and the quality of a patient’s relationship with health workers administering vaccines.3 Nigeria experiences similar challenges, with wide regional variation in access to health services that hinders national efforts to increase immunization rates.1