Immunisation for African children and adults

Caleb Ihuarulam

Caleb Ihuarulam

Immunisation, According to the World Health Organization (WHO), is when a person receives a vaccine that helps them become resistant to an infectious disease. In other words, it is the artificial process of inducing immunity.

Many regions in Africa face challenges with access to proper healthcare.  Immunisation is a proven and cost-effective tool that helps control and eliminate many life-threatening infectious diseases. It is estimated to prevent about 4.4 million deaths annually. Despite this number, there are still over 20 million children who are denied life-saving immunisations annually.

The 2021 Multiple Indicator Cluster Survey (MICS) shows that immunisation coverage in Nigeria is still low. In the past five years, at least 6.2 million children in Nigeria have missed all their vaccines. Children in Sub-Saharan Africa continue to have the highest rates of mortality in the world at 74 (68–86) deaths per 1000 live births.

This article will shed light on the immunisations recommended for African children and adults, focusing on Nigeria in particular and their importance.

Immunisation for children

The immune system of children takes time to develop. During this process, they are susceptible to any illness in their environment. Illnesses at that early stage can put them at considerable health risk. Some even go as far as maiming or scaring them for life. Immunisation fastens the development of children’s immune systems. It also protects them from illness and helps them recover faster.

Some essential immunisations for children include:

  1. BCG (Bacillus Calmette-Guérin) Immunsation

BCG is the vaccine to prevent tuberculosis and other mycobacterial infections in children. Tuberculosis is a contagious infection caused by Mycobacterium tuberculosis that attacks the respiratory system, particularly the lungs. Nigeria has one of the highest cases of TB, ranking number six in the world and number one in Africa. In 2022, about 87% of new TB cases occurred in the 30 high TB-burden countries, with more than ⅔ of the global total in Nigeria and the Republic of Congo, among other countries. Children under the age of 5 are more vulnerable to getting TB meningitis and bone and joint infections if not treated. BCG is usually administered within the first 48 hours after birth.

  1. Oral Poliomyelitis Vaccine (OPV) Immunisation

OPV has played a vital role in the eradication of poliomyelitis. In August 2020, Nigeria was declared free from wild polio. However, the transmission of the circulating Vaccine-Derived Poliovirus type 2 variant (cVDPV) has continued in Northern Nigeria since 2021. Poliovirus is a leading cause of lifelong paralysis and death in children under five years. WHO recommends and has made nOPV2, an improved oral polio vaccine, available to combat Nigeria’s type 2 cVDPV outbreak. Two drops of OPV are given at birth or before the infant is two weeks old as OPV0.  It is administered again at 6, 10, and 14 weeks as OPV 1, OPV 2, and OPV 3, respectively.

  1. Pentavalent Vaccine (DTP-HepB-Hib) Immunisation

Penta is a 5-in-1 combination vaccine that protects children from these life-threatening infections:

  • Diphtheria: a bacterial throat and lung infection that can lead to airway blockage and myocarditis (inflammation of the heart muscles).
  • Pertussis (whooping cough): a bacterial infection that causes severe coughing fits and difficulty breathing.
  • Tetanus: a bacterial infection that triggers painful muscle contractions and seizures when allowed to fester in wounds.
  • Hepatitis B: a viral infection that causes chronic liver disease, leading to cirrhosis and cancer.
  • Haemophilus influenzae type b (Hib): a bacterial infection that contributes to meningitis, pneumonia, and bloodstream infections like septicaemia (presence of pathogenic bacteria in the blood).

Penta has replaced the hepatitis B and DPT (diphtheria-pertussis-tetanus) vaccine. It is administered in three doses at 6, 10, and 14 weeks, reducing the number of pricks a child receives. The Hepatitis B vaccine is administered to newborns within 24 hours of birth as a standalone vaccine.

  1. Pneumococcal Conjugate Vaccine (PCV)

This vaccine was introduced in Nigeria in 2016 and protects against respiratory diseases. Streptococcus pneumoniae bacteria is the leading cause of pneumococcal-related diseases and death in children under five years. PCV boosts children’s immunity, lowering their risk of bacterial meningitis, pneumonia, and sepsis. This intramuscular injection is usually given at 6, 10, and 14 weeks.

  1. Rotavirus Vaccine

This oral vaccine protects against rotavirus, a common cause of severe diarrhoea and sickness. It boosts the body’s immunity against rotavirus-induced diarrhoea, vomiting, and fever. Infants who have not received the rotavirus vaccine are more vulnerable to gastroenteritis. Gastroenteritis often leads to dehydration, malnutrition, and death. The rotavirus vaccine is administered to children in two doses before 15 weeks – at 6, 10, and 14 weeks.

  1. Measles, Mumps, and Rubella (MMR) Immunisation 

MMR is a single vaccine that protects against three viral and deadly infections. Measles is a contagious infection that causes fever, rash, and respiratory problems. Mumps causes fever, pain, and swelling of the salivary glands. Rubella (German measles) is characterised by fever, inflammation, and joint pain. Without this, children are at a higher risk of blindness, deafness and encephalitis (brain swelling). This intramuscular injection is administered in two doses, at 9 and 15 months.

  1. Meningococcal Conjugate Vaccine (MCV)

MC vaccine is commonly used in the Sub-African meningitis belt, which has the highest disease rates. The Neisseria meningitides group A bacteria cause meningococcal infections. They result in the membranes surrounding the brain and spinal cord inflammation. Brain damage, hearing loss, and seizures are meningitis-related complications. MC vaccine is generally given at nine months.

  1. Varicella (Chickenpox) Vaccine

The Chickenpox vaccination protects the body against the varicella-zoster virus (VZV). It causes chickenpox-like diseases characterised by fever, redness, and itching. Pneumonia, encephalitis and other bacterial illnesses may arise from chickenpox. This vaccination aids in the development of immunity to the varicella-zoster virus. Medical professionals recommend it for all children aged 12 to 15 months. Children above 13 years who do not have chickenpox or the vaccine should receive two doses within 4 to 6 weeks.

  1. Yellow Fever Vaccine

This vaccination provides a defence against yellow fever. Yellow fever is a significant public health issue in Sub-Saharan Africa. It is an infection caused by a flavivirus and transmitted by Aedes mosquitoes. Fever, jaundice, dark urine and bleeding are symptoms of yellow fever. Displaced and street children are at increased risk of high mortality rates. This vaccine is usually given to children at nine months.

Oral supplements like Vitamin A vaccine are included in the immunisation schedule for children and administered at 6 and 12 months. Vitamin A deficiency increases the risk of delayed cognitive development and eye inflammation.

Immunisation For Adults

Adults may be less likely to contract infections but contribute to the spread of infectious illness. Children and people with underlying health conditions are at high risk of contacting them. Consequently, immunisation for adults must be encouraged to improve public health. Adults in Nigeria should get the following routine vaccinations if they haven’t:

  1. Polio Vaccine

Poliomyelitis is a significant public health concern in African countries. Adults will have an increased risk of paralysis and fatal consequences if this immunisation is not received. As a result, even adults vaccinated as children need to be immunised against polio. Oral polio (OPV) and inactivated polio (IPV) are administered.

  1. Tetanus and Diphtheria Vaccine (Td)

The Td vaccine combines tetanus and diphtheria components with a lower diphtheria antigen concentration. The Clostridium tetani bacteria found in dust, saliva, and soil cause tetanus. This bacteria gets into the body via open wounds or cuts and releases toxins. Lockjaw, another name for tetanus, can lead to suffocation, muscle spasms, and heart problems.

There has been an unusual outbreak of diphtheria in Nigeria since December 2022. Corynebacterium diphtheriae causes it and affects the nose and throat. Breathing problems and skin ulcers are common symptoms of diphtheria. Booster shots are recommended for older children and adults every ten years to maintain immunity. Neonates will receive protection via transferred antibodies from their mothers during each pregnancy.

  1. Measles, Mumps, and Rubella (MMR) Immunisation

MMR provides immunity from measles outbreaks and mumps and rubella, common in parts of Africa. Measles, characterised by a prominent rash, attacks the throat and lungs. Mumps causes pain and swelling of the testicles in men. Rubella can lead to congenital disabilities in pregnant women. Two doses of MMR vaccine will be given 28 days apart to:

  • People who have no evidence of immunity to these diseases
  • People who did not receive the vaccination as children
  • Students
  • Healthcare personnel
  • Older people
  • People with Human Immunodeficiency Virus (HIV).

Pregnant women are exempted from this vaccination as it can pose threats to the foetus. Women who have received this vaccine must wait four weeks before getting pregnant.

  1. Hepatitis B Vaccine (HBV)

HBV protects against the hepatitis B virus, transmitted through blood, semen and other body fluids. HBV is for adults not immunised as children. This also covers persons who are at a higher risk of contracting hepatitis B, such as health workers, people who inject drugs, and people who have several sexual partners.

  1. Yellow Fever Vaccine

Yellow fever typically causes severe jaundice, bleeding, and deadly complications such as organ failure and death. Yellow Fever vaccine is essential for persons who live in or travel to places with high transmission rates. Areas, particularly in central and southern regions of Nigeria, such as Enugu, Ondo, Oyo, and Delta states, are reported to have high yellow fever cases. People who work high-risk jobs, like mining, construction workers, and farmers, are at increased risk of severe yellow fever without this vaccination.

  1. Human Papilloma Virus (HPV) Immunisation

This vaccine protects against human papillomavirus (HPV). HPV is a sexually transmitted virus that can cause genital warts and cancer in severe cases. It poses the risk of genital warts, cervical, vulvar and vaginal cancer in women. Pap screenings and HPV tests help detect cell changes, which helps to prevent cervical cancer. Women between the ages of 21 and 65 are encouraged to get pap smears every three years. After three routine smears, women over 65 can discontinue testing. Men may develop genital warts, as well as penis and anus cancer, in rare cases. Anal pap smear examinations may show cell abnormalities, but they do not screen for HPV. This vaccination is essential in preventing the transmission of HPV.


Adults are also encouraged to get vaccines based on risk factors and seasonal outbreaks. Some of these include:

  • Varicella (chickenpox)
  • Influenza (flu)
  • Rabies
  • Meningococcal (meningitis)
  • Pneumococcal conjugate
  • Haemophilus influenzae type b (Hib)
  • Hepatitis A


A routine immunisation schedule boosts each individual’s immunity and improves general public health. Kindly consult your doctor about which vaccinations you need, when you should take them, and other important information.

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Caleb Ihuarulam

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