How a new vaccine stamped out a meningitis flare-up in Nigeria's Jigawa State
The use of new Men5CV in meningitis-hit Nigerian communities has proved to be a game changer. Afeez Bolaji visited Jigawa to learn more.
- 24 October 2024
- 7 min read
- by Afeez Bolaji

Zakariyau Marafa’s gravelly voice pitched up as he and his colleagues cracked jokes at the reception of Garin Chiroma Primary Health Centre. The relaxed ambience of the hospital, which is located in the heart of northwestern Nigeria’s Jigawa State that Friday, 11 October, was in sharp contrast to the tense atmosphere at the facility some eight months previously, when health workers were overwhelmed by an outbreak of meningitis – an often rapidly deadly inflammation of the tissues surrounding the brain and spinal cord that can be caused by bacterial, fungal, viral or parasitic infections.
Many patients were admitted with high fevers, severe headaches, stiffness of the neck, seizures and vomiting – all common symptoms with meningitis, says Marafa, who heads the hospital. Gagarawa alone – the local government area (LGA) which hosts Garin Chiroma PHC – recorded about 300 suspected cases. Frontline workers were overstretched; the tidal wave of patients forced them to do extra shifts and work round the clock, he reveals.
“We referred the patients to Gumel General Hospital after giving them first treatment,” Marafa adds.
Testing revealed that the outbreak, which spanned Gagarawa, Gumel, Babura, Birniwa, Maigatari, and Sule Tankarkar LGAs, had been precipitated by the bacterium meningococcus C, meaning that Jigawa was dealing with a life-threatening meningitis strain – one that affects mainly children and teenagers.
“The availability, affordability, and accessibility of this vaccine can give hope in the fight against meningitis. There is a need for trust and political will to implement the vaccine roll-out. This was clearly evident in Nigeria being the first country involved with the Men5CV campaign.”
- Dr Ama Umesi, Men5CV researcher
New weapon
But at the peak of the outbreak in March, Nigeria received a consignment of the new Men5CV vaccine from a Gavi-funded global stockpile, delivered by the United Nations Children’s Fund (UNICEF) – enough to immunise about 1 million people in Jigawa. A single shot would provide protection against five strains of epidemic-causing meningococcus bacteria (A, C, W, Y and X).
During a tour of the rural communities where the vaccine was administered, health officials and locals tell VaccinesWork that the roll-out led to a remarkable turnaround in curtailing the spread of the disease.
“The introduction of Men5CV brought a huge relief,” says Marafa, who doubled as a vaccinator during the five-day mass vaccination campaign. “We were moving from one community to the other to vaccinate people and the turnout was very impressive. Over 1,200 people were vaccinated in the areas I visited.”
Though Meningitis A vaccines managed to seriously knock back the brutal, large-scale and recurrent outbreaks that plagued the so-called ‘meningitis belt’ of Africa until around 2010, meningitis, especially cases precipitated by bacteria other than meningococcus A, remains a public health problem of serious concern in sub-Saharan Africa. Nigeria recorded 4,915 suspected cases in the 2023 and 2024 seasons alone.
The disease can be very complicated to manage, Dr Musa Shaibu remarks, as he reflects on the dozens of patients treated at the Gumel General Hospital’s isolation centre. He, however, acknowledges that the burden reduced drastically following the vaccine roll-out.
“I hope the vaccination will be sustained to fight off this disease. It is very effective and remains the best means of preventing outbreaks,” he says.

Squashing the outbreak
As the outbreak gathered pace, the Jigawa State government alerted local and international partners, including the Nigeria Centre for Disease Control and Prevention, and the World Health Organization, requesting a vaccine to stop the raging spread, state immunisation officer Dr Hassan Dauda recalls.
Within a short time, the state received the requested Men5CV doses, and the vaccination campaign was organised in two phases, with three LGAs covered in each phase.
“The cases started coming down after the exercise. After the roll-out, we did close monitoring so that if there is any reaction, we can quickly manage it. For 25 weeks, we did not detect any case of AEFI [adverse event following immunisation],” he says.
UNICEF communication officer in Nigeria, Samuel Kaalu, seconds Dauda’s account, saying Men5CV has significantly brought down the number of reported cases, and has prevented meningitis-related deaths in Jigawa communities.
Based on cohort monitoring for 20,000 patients, Kaalu further explains, just one week after the vaccination campaign started, no new infections would be reported. In other words, the vaccine helped quash the outbreak in Jigawa.
“A total of 945,043 were reached with Men5CV in Jigawa, for children aged 1–19 years. Taking into cognisance that this was a new vaccine, UNICEF supported the building of the technical skills of the health care workers, and that contributed significantly to the successful roll-out of the vaccines,” Kaalu said.
A post-vaccination campaign survey conducted in the six LGAs showed over 85% coverage, Kaalu reveals, expressing confidence that this rate of coverage has the potential to head off future outbreaks, too.
Future-proofing?
State immunisation officer Dauda hopes that Men5CV will prove to be a far-reaching solution to the meningitis puzzle, observing: “Last year, there was a similar [meningitis] outbreak that was Type A. This year, it was Type C. The easiest way to address that [variety] is the use of Men5CV, which acts on different micro-organisms causing cerebrospinal meningitis.
“Aside from vaccination, we upgraded the laboratory to detect the bacteria causing the disease. We also trained health personnel on case management and engaged community informants to report cases very early. Drugs were provided at the referral centres where cases were managed, and we intensified routine immunisation so that children would be well protected,” he said.
‘The Saviour’
Nuran Baba, ward focal person at Garin Chiroma in Gagarawa, calls the vaccine “the saviour”.
“It was very serious. Many people were hospitalised. The vaccine was the saviour. Since the vaccination exercise, I am not aware of any case of meningitis in this community and its environs,” he says.
Mujitafa Danladi, a community leader in Gagarawa Tasha, firmly believes that a sustained vaccine intervention can completely suppress meningitis.
“It is a killer disease,” Saratu Adamu of Birniwa LGA remarks crisply. “I was very happy about the roll-out. I took the vaccine, and nothing happened to me. Many people also did. A few people were initially afraid, but they were eventually convinced to take it.”
Overcoming social hurdles
Because the roll-out coincided with the Ramadan fast, a key pillar of Islam, the state immunisation officer says a number of locals eligible for the vaccine were hesitant to take the shot until religious leaders convinced them it wouldn’t invalidate their fast.
“Also, schools were on holiday. The vaccinators did extra work by reaching eligible students in their various homes. Nearly a million people were vaccinated, and it was a huge success,” Dauda said.
Though the vaccine was targeted at younger people, 45-year-old Musa Ismaila, a community leader in Gumel LGA, made an example of himself, to persuade parents reluctant to get their children vaccinated.
“Initially, we didn’t take meningitis seriously until the situation escalated. Many children were infected. Two of my neighbour’s children came down with the disease. I would say the vaccine changed the situation for good. Some people were afraid of the vaccine. I took it as a community leader and that changed their mindset,” he says.

Men5CV a “game-changer” for mission to end meningitis
The timely implementation of Men5CV in countries such as Nigeria, which recently had meningitis C outbreaks, is a step in the right direction towards achieving the global goal of defeating meningitis by 2030, says Dr Ama Umesi, a clinician at Medical Research Council Gambia and the London School of Hygiene & Tropical Medicine (LSHTM), and a member of the research team that worked on the Phase 3 trial of Men5CV.
“As an African researcher, it is exciting and fulfilling seeing research progress to implementation,” Umesi tells VaccinesWork, expressing hope that the vaccine will prevent future meningococcal disease outbreaks.
“The availability, affordability, and accessibility of this vaccine can give hope in the fight against meningitis. There is a need for trust and political will to implement the vaccine roll-out. This was clearly evident in Nigeria being the first country involved with the Men5CV campaign.
“We now have the armour to prevent and combat meningitis in the meningitis belt region. Advocacy, public health awareness, and community engagement have a critical role to play in minimising vaccine hesitancy and increasing vaccine uptake. We have a role to play in this fight against meningitis,” she adds.
Brian Davies, head of health insights and policy at Meningitis Research Foundation, describes Men5CV as “a game-changer” in the efforts to end meningitis epidemics and outbreaks in the African meningitis belt.
“Its importance cannot be overstated. It has the potential to reduce long-term disability and deaths due to meningitis in a region that has historically been vulnerable to epidemics and outbreaks. Making sure the vaccine reaches the communities that need them could eliminate meningococcal meningitis epidemics in Africa – a significant step on the road to defeating meningitis by 2030,” Davies notes.
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