Nigeria’s first malaria vaccine roll-out is greeted by an expectant population
The race to save Nigeria’s children from malaria has received a major boost with the introduction of R21/Matrix-M vaccine. Afeez Bolaji reports on the progress of the first roll-out in Kebbi and Bayelsa states.
- 23 January 2025
- 7 min read
- by Afeez Bolaji

Many people were staying indoors on the hazy, cold morning of 13 January in Birnin Kebbi, the state capital of Kebbi in northwestern Nigeria, but nursing mothers defied the wintry weather at 08:00 that Monday to take their children to the Maternal and Child Health Clinic in the city centre for their malaria vaccines.
A blend of chuckles wafted through the clinic premises as the women settled on neatly arranged benches with their babies, waiting for the vaccination exercise to begin. Soon, two neatly dressed immunisation officers appeared to counsel the gathered group on R21/Matrix-M, the newly introduced malaria vaccine.
The mothers already know that the vaccine is a four-dose series. Children aged between five and eleven months are eligible for a first dose. Two further doses follow at four-week intervals, succeeded by a fourth and final dose at least six months after the first. "We are very excited about this vaccine. It will protect our children against malaria, which is very common here in Kebbi," Safina Muhammed said, after her five-month-old daughter, Aisha, received the first dose. "I would have loved it if my other children took it too, but they have passed the eligible stage."
Malaria is highly endemic across Africa, and Nigeria is the country grappling with the world's single highest case-load – about 27% of the global burden, and about 30.9% of the 569,000 deaths recorded worldwide in 2023.
As in the rest of the region, children under five account for about 76% of the fatalities. But with two similar path-breaking malaria vaccines, known as R21 and RTS,S, now rolling out in 17 African countries, experts hope these grim figures will drop. It's too early to confidently project the extent of that impact, but data gleaned from the three-year pilot project, which ran in Kenya, Ghana and Malawi from 2019, found that malaria vaccination was correlated with a reduction in all-cause mortality in the target age group by a significant 13%, as well as a 22% drop in hospitalisation for severe clinical malaria among eligible children.
A new shield for Nigeria
In October 2024, Nigeria received its first 1 million doses of the malaria vaccine with support from Gavi, the Vaccine Alliance, UNICEF, and the World Health Organization (WHO). The vaccination campaign was launched early in December, with the vaccine integrated first into the routine immunisation schedules of Kebbi and Bayelsa states, which have Nigeria's highest malaria burden.
Hafsat Shehu's seven-month-old son, Abdul-Aziz, had just received the second dose at the Birnin Kebbi clinic. Shehu beamed as she spoke of the relief the vaccine has brought to her and many families in her community.
"My son took the first dose in December. [In the past] we have spent the money we should have used for feeding to buy malaria drugs. The disease has dealt a heavy blow to many families in Kebbi. One of my neighbours lost their child to malaria a few years ago. It was a really sad experience. So, I was very happy when I heard about the vaccine," Shehu said.
“Parents, especially those whose children have sickle cell, don’t joke with this malaria vaccine at all. They are always here to get it.”
- Victoria Bankole, immunisation officer, Kebbi
Vaccine meets overwhelming acceptance
The turnout for the malaria vaccination has been impressive, health workers at primary health centres in Kebbi and Bayelsa states told VaccinesWork.
Since the roll-out began, more than 100 women have brought their children here on each weekly immunisation day – which falls on a Monday at this facility – to take the vaccine, said Victoria Bankole, an immunisation officer at the Maternal and Child Health Clinic.
"We also immunise up to 30 children on every other day of the week. On immunisation days when there is a crowd, nursing mothers fight with each other because they are all eager to get their children vaccinated. Parents, especially those whose children have sickle cell, don't joke with this malaria vaccine at all. They are always here to get it," she added.
Agnes Sunday, a nurse at Comprehensive Health Centre, Azikoro, in Bayelsa State, explained that her facility has campaigned publicly to ensure that every eligible child completes the four doses.
Nearly 200 children receive the malaria vaccine every week at the centre, she said, adding that parents are advised to not let down their guards even once their children have been immunised.
"We sent messages to mothers to remind them of the time to bring their children for the next dose. We always encourage them to let their children complete the doses for the vaccine to be effective.
"We also counsel the mothers not to expose the children to mosquito bites. Despite that the children have taken the vaccine, they still have to sleep inside insecticide-treated [mosquito] nets. Parents should keep their environment clean, and seek treatment immediately they notice malaria symptoms in their children," Sunday said.
Mobilisation strategies paying off
Significant progress has been made in both Kebbi and Bayelsa states since the launch of the roll-out, with "thousands of eligible children" already given the first dose, Remi Adeleke, head of public relations with the National Primary Health Care Development Agency (NPHCDA), which coordinates vaccine roll-outs nationwide, told VaccinesWork.
"Community engagement initiatives have increased awareness and acceptance of the vaccine. The NPHCDA has actively partnered with state governments, traditional leaders, healthcare providers, and community-based organisations to mobilise communities. Public awareness campaigns through radio, social media and interpersonal communication channels have played a crucial role in promoting acceptance of the vaccine.
"There is gradual expansion of the roll-out to additional states as detailed in Nigeria's malaria vaccine scale-up plan. We are also strengthening cold chain infrastructure to ensure the safe storage and transportation of vaccines and training health care workers to support vaccine administration. The NPHCDA is leveraging technology for real-time data tracking and monitoring vaccine distribution," he explained.
Adeleke said the NPHCDA is collaborating with the donor and partners to get more supplies to shore up the one million doses received, adding that the agency is committed to making the malaria vaccine accessible to all eligible children across Nigeria.
Professor Seiyefa Brisibie, Bayelsa's Commissioner for Health, said the plan is to vaccinate 7,500 children in the state every month, and over 98% of that target was met in the first month.
He added that 7,371 children were vaccinated in December 2024 with the first dose. "The second dose has started in all the facilities, and eligible children are already taking it. The ACSM (advocacy, communication and social mobilisation) team carried out sensitisation meetings at the ward levels with major stakeholders being part of it. There were roadshows, radio programmes, radio jingles as well as television jingles to mobilise parents to bring their children.
"In two local government areas, an e-tracking app was piloted to help mobilise the clients to return for the subsequent doses when due. We're also making use of our regular RI tracking systems such as tickler boxes, house-to-house mobilisers to ensure they come back for subsequent doses," he said.
Brisibie, a professor of family medicine, said the State Primary Health Care Board has put in place a system to deal with complaints of adverse effects after immunisation (AEFI), noting that parents have been properly educated and asked to return to the facility if they notice any symptoms in their children.
"There are referral hospitals designated to manage serious cases at no cost to the parents. The cost of management of AEFIs is borne by the state healthcare board," he added.
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Paediatric vaccine
The national coordinator of the National Malaria Elimination Programme (NMEP), Dr Godwin Ntadom, said adults living in malaria-endemic areas tend to develop partial immunity against malaria after being repeatedly infected, and are less likely to die from the disease than young children.
"Most people who die of malaria are children below five years. When children grow beyond that age, the risk of dying from malaria reduces. What kills the children is severe malaria infection. It gets complicated, and the child dies from those complications. So ,what the vaccine does is protect them from severe malaria.
"We have started with Bayelsa and Kebbi, and it will be scaled to other states. NMEP is working with NPHCDA on the roll-out. We are also documenting the challenges and will work on them. But the vaccine is safe, effective, and is the best for children for now. The focus is primarily to ensure that children under the age of five do not die of malaria," Ntadom said.
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