Childhood Immunisation in Nigeria: How It Works
The vaccines are free and the system is designed to reach every ward. Roughly 2.1 million children have still never received one.
Routine immunisation is the highest-return intervention in public health, and Nigeria's programme is free at the point of delivery. Understanding who runs it, and why so many children are missed, explains a great deal about the wider health system.
Who delivers it
NPHCDA sets policy and manages vaccine procurement and the cold chain nationally, with support from Gavi, UNICEF and WHO.
State Primary Health Care Boards and local government PHC departments deliver it — at ward-level primary healthcare centres through fixed sessions, and through outreach and mobile teams for communities the clinics do not reach. Periodic supplementary immunisation activities and campaigns run alongside.
Funding is a mix of federal counterpart funds, Gavi support and the Basic Health Care Provision Fund.
What "zero-dose" means
A zero-dose child has never received any routine vaccine at all. Not a partial course — nothing.
Approximately 2.1 million Nigerian children are zero-dose, on WHO and UNICEF estimates for 2026.
This is the measure that matters most, because it identifies children who are not merely behind on a schedule but entirely outside the system. A zero-dose child usually indicates a household the health system has never reached, which means it is also missing antenatal care, growth monitoring and everything else delivered at that contact point.
What the coverage data shows
The most recent national survey is the Nigeria Demographic and Health Survey 2023–24.
We could not extract the specific coverage percentages from the published tables. Reported secondary figures indicate that about one-third of children aged 12 to 23 months are fully immunised, and that 31% of Nigerian children are unvaccinated.
We are flagging that rather than presenting precise figures we could not verify. If you need exact Penta3, MCV1 or zero-dose percentages with a zonal breakdown, go to the NDHS report directly.
The Big Catch-Up
NPHCDA reported that as at 31 March 2026, over 2 million previously zero-dose children had received a first dose, and 3.4 million IPV doses had been administered under the Big Catch-Up campaign.
That is a substantial operational achievement, set against an estimated zero-dose population of 2.1 million — which tells you the campaign is running roughly at the scale of the problem, while new children are born into it continuously.
What is at stake
Gavi estimates that unvaccinated children account for about 39% of vaccine-preventable under-five deaths in Nigeria — roughly 337,000 child deaths a year. At least 41% of Nigerian under-five deaths are attributed to vaccine-preventable disease.
Those are not deaths from exotic conditions. They are measles, pertussis, pneumococcal disease and rotavirus — all of which have a vaccine that is free at a Nigerian primary healthcare centre.
Gavi and what happens next
Nigeria is in Gavi's accelerated transition framework, meaning government co-financing rises as Gavi support tapers.
On 4 August 2026, Gavi CEO Dr Sania Nishtar announced in Abuja, alongside President Tinubu, more than US$500 million over five years — roughly US$100 million a year — to support immunisation and health system strengthening, with Nigerian government contributions expected to grow steadily.
There is no confirmed date for full self-financing, and Nigeria is not on Gavi's fully self-financing list. We could not confirm Nigeria's current annual co-financing obligation or whether payments are up to date — both matter, because co-financing default has historically interrupted vaccine supply.
Why the north lags
The documented reasons overlap with everything else in northern health and education: distance to a functioning facility, insecurity preventing outreach teams from travelling, and in some communities, resistance rooted in a history of mistrust.
On that last point, endorsement by traditional and religious leaders has repeatedly proved decisive in northern immunisation campaigns — which is why vaccination drives in the region run through emirate and mosque structures rather than around them.
Frequently asked questions
Are vaccines free in Nigeria? Routine childhood immunisation is free at government primary healthcare centres.
What does zero-dose mean? A child who has never received any routine vaccine.
Where do I take my child? Your nearest primary healthcare centre. The schedule is displayed there.
How many Nigerian children are unvaccinated? Around 2.1 million are zero-dose on 2026 WHO and UNICEF estimates.
Sources
- Zero-dose estimate, Big Catch-Up figures and Gavi mortality estimates — The Sun, 30 April 2026
- Unvaccinated share — The Guardian Nigeria
- Gavi commitment, August 2026 — FundsforNGOs
- NDHS 2023–24 key indicators — DHS Program (PDF)