… Let’s Strengthen Routine Immunisation Systems To Reach Zero-Dose, Under-Immunised Children – Save The Children
Nigeria has an estimated 2.1 million zero‑dose children, defined as children who have never received a single routine vaccine, according to WHO and UNICEF.
An additional 2.3 million children are under-immunised, meaning they have started but not completed routine vaccination schedules, according to Gavi estimates.
Only about one‑third of Nigerian children aged 12–23 months are fully immunised, leaving millions exposed to vaccine‑preventable diseases according to Nigeria Demographic and Health Survey.
At least 41% of under-five deaths in Nigeria are vaccine-preventable, per the global burden of disease (GBD) analysis, with Gavi estimating that unvaccinated children account for 39% of such deaths (around 337,000 annually).
As the world marks World Immunisation Week 2026 (24–30 April), under the theme “For every generation, vaccines work,” Save the Children Nigeria is calling for renewed commitment and coordinated action to reach zero‑dose and under‑immunised children across Nigeria, particularly in underserved urban and peri‑urban communities in Lagos and Kano States.
In a release by Save the Children Nigeria, Nigeria remains one of the countries with the highest burden of children missed by routine
immunisation services. While 2.1 million children have never received a single vaccine, a further estimated 2.3 million children are under-immunised, reflecting missed opportunities within the health
system and persistent access barriers. Together, these gaps undermine child survival and put a strain on health services. This makes Nigeria the country with the second-highest number of zero-dose children globally.
Evidence from the Global Burden of Disease Study revealed that vaccine-preventable diseases such as pneumonia, diarrhoeal diseases, and meningitis continue to drive child mortality in Nigeria.
Reaching children who have been consistently missed by immunisation services is critical to improving child survival and achieving equitable health outcomes nationwide.
Immunisation remains one of the most cost‑effective public health interventions, saving millions of lives globally each year. However, in Nigeria, many children continue to miss routine vaccinations due to limited access to services, weak follow‑up and data systems, misinformation, harmful social and gender norms, and gaps in community engagement.
Duncan Harvey, Country Director, Save the Children Nigeria, stated that vaccines have protected families for generations, yet millions of Nigerian children are still missing out on this basic right. Reaching zero dose and under-immunised children require strong health systems, trusted community engagement, and sustained investment. World Immunisation Week is a reminder that every child, regardless of where they live, deserves access to life-saving vaccines.
These challenges threaten progress in child survival and leave children unnecessarily exposed to preventable illness and death. Children who are unvaccinated or under‑immunised often face multiple and overlapping challenges such as malnutrition, poor access to water and sanitation, poverty, and limited access to quality primary health care, which further increases their risk of severe illness and death.
World Immunisation Week 2026 provides an opportunity to reinforce confidence in vaccines, strengthen routine immunisation systems, and ensure that children of every age and background are protected.
The theme underscores the proven role of vaccines in protecting children, families, and communities for generations and their continued importance in safeguarding the health of today’s children and those yet to be born. Across Africa alone, nearly 20 million lives have been saved through measles vaccination programmes since 2000, demonstrating the profound impact of sustained immunisation investments on child survival.
In Lagos and Kano States, Save the Children Nigeria, through the Better Opportunities for Optimal Services and Targeted Immunisation (BOOST) Project, is working with government and community
partners to improve equitable access to vaccination services, strengthen demand among caregivers, and create an enabling policy and social environment that prioritises zero-dose and under-immunised children.
The BOOST Project, funded by GlaxoSmithKline (GSK), is a four-year initiative (2024–2027) implemented in collaboration with the government. The project aims to identify and test strategies that drive immunisation uptake leading to reductions in reductions in zero-dose and under-immunisation among children in selected LGAs of intervention in both Lagos and Kano states.
“I am very happy for vaccinating my child and I am appealing to every mother in my community to take their children for vaccination because the injection is very important for the good health of their children” said Mama Ismail, a BOOST Project participant in Lagos State.
As part of World Immunisation Week 2026, Save the Children urged the government, partners, communities, and stakeholders to:
1. Strengthen routine immunisation systems to reach zero-dose and under-immunised children, especially in underserved settlements.
2. Invest in quality data use, defaulter tracking, and multiple contact points for vaccination within the health system.
3. Support health workers with the skills and resources needed to provide respectful, high-quality immunisation services.
4. Address misinformation and harmful social norms through trusted community leaders and inclusive engagement approaches.
5. Increase domestic and partner financing for immunisation and primary health care to ensure sustainable coverage for every generation.
This World Immunisation Week 2026 is a call to action to protect every child from preventable diseases and ensure no child misses out on life-saving vaccines.