Routine immunization: We have seen improvements but overall coverage remains low --- Mrs Kemi Oshodi, State Immunization Officer, Lagos

By Sola Ogundipe 

Concerns have been raised over declining routine immunisation coverage across several Local Government Areas in Lagos State as revelations show that 63,597 children were unvaccinated in the state between January and September 2025.

Speaking at stakeholders dialogue of key players in the Lagos State health sector organised by Save the Children International under the GSK supported Better Opportunities for Optimised Targeted Intervention (BOOST) project for Zero-Dose and Unimmunised Children in Nigeria,  the State Immunisation Officer, Lagos, Mrs. Kemi Oshodi, decried uneven progress of routine immunisation across the LGAs, noting that some councils failed to meet even minimum coverage targets. 

In a review of the 2025 Quarter 3 Routine Immunisation report for Lagos State, Oshodi stated: “We have seen some improvements, but our overall coverage remains below expectation. For a megacity like Lagos, 78 per cent coverage is not where we should be. From the state’s data, Lagos operates 874 primary health facilities, of which 334 offer routine immunisation services. 

“Out of five tertiary health institutions, four currently administer vaccines. The state uses two population benchmarks, the Lagos Bureau of Statistics estimate of 30.9 million residents and the national projection of 15.1 million,  both based on the 2006 census with a 3.2 per cent annual growth rate,“ Oshodi said.

According to the state’s data, Lagos operates 874 primary health facilities, of which 334  offer routine immunisation, while four out of five tertiary health institutions currently offer routine immunisation services, nevertheless, the State fell short of its vaccination targets across all antigens.

“For instance, coverage for penta 1 stood at 78 percent by Quarter 3, below the expected 90 per cent threshold, while measles 2 coverage dropped to as low as 21 per cent in some LGAs.”

Further, she said rotavirus vaccine coverage was affected by recurrent national stockouts, and lamented poor uptake of the measles 2 vaccine largely because caregivers fail to return when children reach 15 months.

Oshodi explained that the state uses two population benchmarks, the Lagos Bureau of Statistics estimate of 30.9 million residents and the national projection of 15.1 million  both based on the 2006 census.

It was gathered that Surulere and Kosofe LGAs were flagged for particularly poor performance, even as Alimosho LGA, which has the state’s largest child population, recorded encouraging numbers in absolute figures, although still showed large gaps in overall coverage and a high number of unvaccinated children.

“Surulere has consistently underperformed despite full data entry. We’ve had several engagement meetings with them and hope to see progress by the last quarter. Alimosho alone accounts for more than 14,000 unimmunised children, and by year’s end, we may be looking at up to 20,000 unvaccinated children,” Oshodi warned.

Citing multiple factors for the lagging numbers, including vaccine stockouts, human resource shortages, and vaccine hesitancy in certain communities, the SIO called for more public awareness and enlightenment.

“Many parents believe that once their child turns one, vaccination ends. Others are simply unaware that they need to return for the second measles dose.”

Among others, she pointed at community distrust of government health initiatives. For instance in parts of Surulere such as Itire, Coker, and Aguda, officials reported vaccine hesitancy linked to political tensions and misinformation.

Oshodi cited a development from the Mile 12 area of Kosofe, where immunisation turnout dropped drastically after a beloved male health worker was temporarily transferred. “He’s very friendly with the community. When he was moved, coverage at that facility fell sharply,” she recounted.

According to the Lagos Bureau of Statistics, Lagos has a population of N30.9 million. Children unvaccinated (Jan–Sept 2025) totalled 63,597; LGAs with highest number of unimmunized children are Alimosho, Kosofe, Surulere,been as measles 2 coverage dropped as low as 21 per cent in some LGAs, while HPV vaccination coverage exceeded targets in five  pilot LGAs

The review showed that across all antigens, Lagos fell short of its vaccination targets. For instance, coverage for Penta 1 stood at 78 percent by the third quarter, below the expected 90 percent threshold, while measles 2 coverage dropped to as low as 21 percent in some local government areas. 

Multiple factors cited for the lagging numbers, include vaccine stockouts, human resource shortages, and vaccine hesitancy in certain communities. According to Oshodi, logistical barriers such as lack of weekend vaccination options and limited community awareness campaigns, especially in hard-to-reach and highly mobile areas like Ibeju-Lekki and Ikosi-Isheri played a role.

On a brighter note, Lagos recorded strong performance in the HPV vaccination campaign, particularly in school-based programmes targeting girls aged nine years. Oshodi said the school-based strategy has proven most effective, noting that consent is easier to obtain in schools, while it remains a challenge in communities.

Community distrust of government health initiatives also emerged as a recurring barrier. In parts of Surulere such as Itire, Coker, and Aguda, officials reported vaccine hesitancy linked to political tensions and misinformation. 

The state has categorized LGAs by performance, marking Kosofe and Surulere as high-risk councils requiring urgent intervention. Monthly data reviews are ongoing, with a comprehensive Quarter 4 assessment scheduled for January 2026. 

Despite current setbacks, Oshodi expressed optimism. “We’ve engaged underperforming LGAs and shared strategies for reaching children in densely populated areas. With continued partner support, we expect significant improvement by the end of the year,” she said.