As Director of Nursing and the Local Immunization Officer in the Ahiazu Mbaise local government area in Imo State, Margaret Uwakwe has seen first-hand the effects of not getting vaccinated.
She recalls once trying unsuccessfully to change the minds of parents who refused to vaccinate their children. A few years later, two of their children died of measles – a vaccine-preventable disease.
“It was a very sad situation,” said Margaret. “Because of that, I have always seen my profession as a vocation. It’s a very important job, as it helps prevent so many deaths. I don’t think I will ever get tired of talking to people about the importance of immunization.”
Vaccines are one of the great breakthroughs of modern medicine, saving millions of lives every year, at a low cost. Africa experienced the eradication of the wild poliovirus last year due to the power of vaccines and the dedication of immunization workers.
In 2020, the world witnessed an alarming decline in global vaccine coverage and uptake due to the COVID-19 pandemic, which disrupted the delivery of immunization services. A 2020 report by UNICEF and WHO showed that the West and Central Africa region is much further behind in vaccination than other regions, with Nigeria topping the list of countries with high numbers of children who did not receive their vaccines for diphtheria, tetanus and whooping cough (DTP1) in 2019.
Part of Nurse Margaret’s job is to make sure vaccines are available from the local government, and to educate workers on new vaccines and follow through with vaccination campaigns.
In Nigeria, immunization coverage varies dramatically, and all states fall below the global goal of 90 per cent coverage for three doses of pentavalent vaccine, which protects children against five major diseases: diphtheria, tetanus, pertussis (whooping cough), hepatitis B and Haemophilus influenzae type b. But within the country, the south-east region has the highest immunization rate. This is a point of pride for Nurse Margaret.
“My local government area was among the three that were selected for documentation evaluation during the polio eradication exercise and it came in first place, with 99 per cent coverage,” she said. “I am proud that I contributed to Nigeria being a polio-free nation.”
Many people aren’t able to seek vaccination due to poor road access in rural communities and difficulty in finding health centres. Others avoid vaccines due to incorrect beliefs about their safety.
As an experienced immunization officer, Nurse Margaret is not surprised that there are rumours and conspiracy theories surrounding the new COVID-19 vaccines, as she has seen this kind of hesitancy several times during the course of her career. She worries that this could hurt immunization rates and therefore increase sickness and death from other vaccine-preventable diseases.
“These things didn’t just start with the COVID-19 vaccine. We also experienced similar rumours and conspiracy theories during immunization for monkeypox and meningitis,” she said. “We also had to battle with the fake news during the measles campaign and during the Ebola outbreak. So, we are used to misinformation.”
With a struggling health system and too few health workers and facilities within reach, frontline workers like Nurse Margaret are key to keeping children and adults healthy and vaccinated.
UNICEF, together with partners and donors, is working with the Nigerian Government to ensure that health workers like Nurse Margaret can continue to deliver routine immunization services in a safe way, even as the COVID-19 pandemic rages.
