Immunization is an important aspect of the health public system because it helps eliminate and prevent infectious diseases. Disease has been a major threat to human life throughout the history of the human kind. However, the invention of vaccination, which started with the discovery of penicillin, has helped the human race to combat many diseases that would have otherwise wiped out the human race from the face of the other. Despite the benefits of a good vaccination system, developing countries especially in Africa continue to struggle with infectious diseases owing to inadequate immunization and vaccination systems. This compilation will compare the vaccination systems in various two developing countries namely Nigeria and Angola respectively. The compilation will look at the unique situations that cause disparities in the two countries’ vaccination systems. The vaccination systems of Nigeria and Angola will also be compared against the UK, which represents more economically developed countries (MEDC).
Vaccination System in Nigeria
The Nigerian Vaccination system is called the National Program of Immunization (NPI). The system suffers from perennial challenges such as religious beliefs and ethnicity, which hinder success of the vaccination system. These problems are compounded by the fact that the country is one of the most populous countries in Africa. At the close of 2011, the Nigerian population was estimated to be 167 million. During this time, the Expanded Program on Immunization (EPI), which commenced in 1978 drove the country’s vaccination system (Ophori et al., 2014). The EPI targeted children below two years. The system had a mixture of success and failure due to unique challenges facing Nigeria (Ophori et al., 2014). Despite the challenges, the country through the EPI managed to achieve the global objective of childhood immunization of 81.5 percent during the 90s (Ophori et al., 2014). However, company started on a recessive trend where the levels of childhood immunization coverage fell gradually. In 1996, the national data on immunization coverage showed that Nigeria had immunization coverage of 30% for all diseases and antigens (Ophori et al., 2014). A worrying trend was recorded in 2003, when the national immunization coverage was reported at 15% (Ophori et al., 2014). This is among the lowest national immunization coverage the world over. It serves to explains the reason why many children in Nigeria are prone to infectious diseases.
A vaccination system is important in guaranteeing a long and healthy life for the citizenry in a given nation. More so, vaccinations are important in protecting children against diseases such as diphtheria, tetanus, pertussis, measles and Polio. These diseases are the leading causes of childhood mortality and morbidity. Therefore, it goes without saying that maintaining a high immunization and vaccination coverage is an important goal for any nation and its public health system as a way of reducing childhood mortality and morbidity that are associated with infectious diseases. Similarly vaccination and immunization help delay more than two million deaths around the world every year (Odusanya et al, 2008; World Health organization, 2009). Nevertheless, diseases that could be prevented with vaccines have remained the leading causes of childhood mortality. Center for Global Development (2005) reports that infectious diseases that could be prevented through vaccination cause three million deaths every year.
Today the National Program on Immunization has replaced the EPI vaccination and immunization system in Nigeria. NPI is tasked with delivering the following children vaccines
BCG: this vaccine is given immediately at birth or at the earliest possible time after birth
OPV (Oral Polio Vaccine)- administered at birth, at 6weeks, at 1o weeks and 14 weeks after birth
DPT (protects against diphtheria, pertussis, and tetanus)
Hepatitis B administered at birth, 6 weeks and at 14 weeks.
Measles: administered on children on attaining 9 months
Yellow fever: given to children at 9 months after birth
The Nigerian vaccination system considers a child as fully vaccinated if the child has all of the above vaccinations including the right dosage where a vaccine has more than one dose. From the above analysis it is clear that Nigeria has a challenged National Program on Immunization (Ophori et al., 2014). In fact, some parts of Nigeria, such as the northern region of Nigeria, have the lowest levels of immunization. nevertheless, this does not occur in a vacuum. There are reasons why the Nigerian National Program on Immunization is mired with challenges. Such challenges are discussed here under (Ophori et al., 2014).
Misperceptions of routine immunization
People in the remote part of Nigeria do not believe that vaccines are for their own good. This is caused by illiteracy and alienation from the urban life. The lack of knowledge about vaccines leads to wild misconceptions that affect the entire vaccination and immunization system (Ophori et al., 2014).
Religious prohibition: the part that has the lowest coverage in Nigeria is the northern Nigeria home to a vast Muslim population (Ophori et al., 2014). The religion influences the peoples’ views on immunization and vaccination which makes the immunization and vaccination system ineffective in those regions thereby dragging down the national immunization childhood coverage (Ophori et al., 2014).
Political problems: the northern region of Nigeria is inhabited by Muslims and has become home to Boko Haram, a terrorist organization that does not recognize the authority of the Nigerian government (Ophori et al., 2014). Political wrangles between the group and the government has led to hostility in the region affecting the immunization activities (Ophori et al., 2014).
Technical challenges: vaccines need to be stored in cold chain equipment. There is a shortage of cold chain equipment’s in Nigeria especially in the rural area, which affects the activities of the National Program on Immunization (Ophori et al., 2014).
Inadequate immunization and Vaccine supplies: Lack of enough funds to purchase enough immunization supplies, as well as vaccines has been a leading perennial challenge for Nigeria (Ophori et al., 2014). As the National Program on Immunization attempts to collaborate with state and local authorities in Nigeria to carry out vaccinations, it still grapples with the problem of resources to achieve childhood immunization coverage.
Vaccination System in Angola
Angola like Nigeria is an African country of the Southern Africa region. Angola’s case is worse than Nigeria’s. Diseases preventable through vaccination are the leading causes of majority of childhood deaths in Angola. According to a case study by De Oliviera and colleagues, it was revealed that immunization coverage of Angolan children is 37%, which is below the target set by the Angolan government (2014). Through the national Immunization program, the Angolan government had set out to achieve immunization coverage of more than 80%. However, research indicates non-adherence to the target (De Oliveira et al., 2014). The same disparity that was reported in different regions of Nigeria was also observed in Angola. The following factors were fronted as the possible reasons behind discrepancies and inefficient vaccination systems in Angola.
Factors affecting the Vaccination System in Angola
Illiteracy : in areas where parents had low level of education or none at all, the importance of vaccination for the children was not comprehended (De Oliveira et al., 2014). Such areas record low childhood immunization coverage.
Forced Migration : vaccination and immunization efforts are made difficult in Angola because migration among the Angolan population has never stopped despite the end of the Angolan civil war. This makes it difficult for the national immunization program to target people who are constantly on the move. Forceful migration, which results from war, is disruptive in nature. Therefore, it makes it difficult to deliver vaccination and immunization services to the population (Avogo, & Agadjanian, 2010). Instability in Africa seems to be a major impediment to health initiatives such as immunization. Note that a similar factor was identified in the Nigerian case described above.
Low-income levels have also been associated with the low childhood immunization levels in the same country. This means that the government has to subsidize health services especially vaccination and immunization services to cater for people in low income levels (De Oliveira et al., 2014).
Barrett investigates a case involving the resurgence of yellow fever in spite of vaccination (2016). Barrett (2016) argues that the insufficient supply of vaccines in Angola has made it impossible to control yellow fever, which is a vaccine-controllable disease. Barrett also notes that a similar case is affecting the DRC (2016).
Vaccination System in the United Kingdom
The UK has a more efficient vaccination system. The system is also up to date because vaccinations are continued or new ones are added in accordance with threats. Across the UK, in England, Scotland, Wales, and Northern Ireland, the UK Department of Health carries out development and coordination of the immunization programs. The system is robust such that vaccines for any new infectious diseases are ready whenever needed. According to Atchison and Hassounah (2015), the department updated its immunization program by adding three vaccines in the period 2013/2014. These vaccines were for oral rotavirus for children, intranasal influenza for children and an adult vaccine for subcutaneous shingles for adults.
Success factors in the UK Vaccination System
Communication : The vaccination system in the UK achieves its objectives because of an elaborate communication system through which it informs the public of the vaccinations it has updated or intends to carry out. Consequentially, people will avail their children for vaccination.
Resources : compared to resources and equipment, the UK is far more endowed than Angola and Nigeria discussed above. As a result, it becomes easy for the national Immunization program in the UK to roll out vaccination efforts to reach a large number of people.
Informed parents : many people are aware of the importance of vaccination and therefore understand the need for having their children undergo vaccination or immunization (Jackson et al., 2015). compared to the African nations discussed above namely Angola and Nigeria where levels of illiteracy are high thus affecting the immunization activity, the UK population is more informed on the importance of such immunization. In such a nation, the influence of religion will not affect the immunization activities.
The UK has a stable political system and well established healthcare system. This means that rolling out a vaccination or immunization program across the country is not a big task as it is for countries facing political upheavals in some parts of their countries.
From the above compilation, it is clear that the importance of vaccination and immunization cannot be understated when it comes to preventing diseases that childhood morbidity as well as mortality. The success of a country’s vaccination and immunization system depends on how it achieves immunization coverage. For the developing represented by Nigeria, which is important in this discussion because it is the most populous nation in Africa, and Angola, which paints a better picture of the challenges African immunization systems face. Conversely, the UK represents the vaccination systems in the developed countries such as large economies. It is clear that level of education, availability of resources, effective communication and political stability/relative peace are important for the success of Vaccination and Immunization.
Avogo, W. A., & Agadjanian, V. (2010). Forced migration and child health and mortality in Angola. Social Science & Medicine (1982), 70(1), 53–60. http://doi.org/10.1016/j.socscimed.2009.09.057
Barrett, A. D. (2016). Yellow fever in Angola and beyond—the problem of vaccine supply and demand. New England Journal of Medicine, 375(4), 301-303.
De Oliveira, M. F. S., Martinez, E. Z., & Rocha, J. S. Y. (2014). Factors associated with vaccination coverage in children < 5 years in Angola. Revista de Saúde Pública, 48(6), 906–915. http://doi.org/10.1590/S0034-8910.2014048005284
Jackson, C., Yarwood, J., Saliba, V., & Bedford, H. (2017). UK parents’ attitudes towards meningococcal group B (MenB) vaccination: a qualitative analysis. BMJ open, 7(4), e012851.
Ophori, E. A., Tula, M. Y., Azih, A. V., Okojie, R., & Ikpo, P. E. (2014). Current Trends of Immunization in Nigeria: Prospect and Challenges. Tropical Medicine and Health, 42(2), 67–75. http://doi.org/10.2149/tmh.2013-13