Pfizer and Moderna have declared open breakthroughs in the inquiry for a COVID-19 vaccine with respective potency rates of 90% and 94.5%. Nigeria has tested about 0.32% of the population. How will it enforce a policy that gets COVID-19 vaccines across to most people in a short period?

Nigeria received nearly 4 million doses from Oxford AstraZeneca at the beginning of March, and about 900,000 have received the first dose.

Johnson & Johnson will deliver 70 million single-dose vaccines later in the year through the African Union.

Nigeria aims to vaccinate 40% of the population this year and a further 30% next year.

The uncertainty for a vaccine that could suppress the pandemic is tremendous.

The New York Times Coronavirus Vaccine Tracker states that 66 vaccines improve the Coronavirus globally. And 11 of these vaccines are in Phase 3 clinical trials. These include vaccines from established manufacturers like Pfizer and AstraZeneca. Even though Moderna and Pfizer's vaccines are relatively tight, regulatory agencies have approved none.

The U.S.government's Operation WARP Speed initiative pledged $10 billion to develop and deliver 300 million doses by January 2021. The WHO is organizing global actions to plan and transmit 2 billion doses by the end of 2021.

Amidst global uproar for a vaccine, the Nigerian government is not far behind. Dr. Osagie Ehanire, the Nigerian Health Minister, states that they plan to get 2 billion vaccines by working with WHO's Access to COVID-19 Tools Accelerator (ACT) - a global device tracking and funding international organizations working on COVID-19 vaccine modification.  

The Nigerian Ministry of Health plans to get extra vaccines through the COVAX Facility, a Gavi-sponsored initiative to guarantee equitable access to vaccines as soon as they are available, particularly for lower-income countries.

It transpires that securing vaccines may not pose the biggest challenge for a COVID-19 vaccination roll-out in Nigeria. Still, once vaccines are guaranteed, various obstacles exist in the delivery and distribution of the vaccine to contain the pandemic.

Covid Vaccine Distribution in Nigeria

The number one obstacle is the existing infrastructure for vaccine distribution in Nigeria. Chikwe Ihekweazu, the Director-General of the Nigeria Center for Disease Control (NCDC), implied that the National Primary Health Care Development Agency (NPHCDA) would oversee the distribution and planning of a COVID-19 vaccine in Nigeria.

The NPHCDA plans on repairing Nigeria's Primary Healthcare System. It receives approximately 45% of the Basic Health Care Provision Fund (BHCF) to get essential drugs, maintain primary health care facilities, equipment, and transportation improve human resource capacity.  

However, the BHCF uses only 1% of federal revenue, and poor data management and accountability may hinder the impact of this initiative.

The Director-General of the Nigeria Center for Disease Control (NCDC), Chikwe Ihekweazu, is optimistic that Nigeria's vaccine distribution is one of the most efficient parts of the public sector.  

COVID Vaccine vs. Polio Vaccine Distribution In Nigeria

Nigeria successfully eliminated polio by using a sophisticated vaccine distribution infrastructure with strategic emergency operations centers. While leveraging existing infrastructure is an excellent strategy, different aspects of the Coronavirus question the counterpart of the existing plan or infrastructure.  

1. We transmit the poliovirus through polluted water and stool. The Coronavirus involves air transmission, making it highly widespread.  

2. Poliovirus primarily affects children under 5 years of age. And COVID infecting all ages, particularly the elderly and those with high-risk comorbid conditions.

These differences translate to a much larger-scale vaccination program for the coronavirus pandemic that poses a significant challenge requiring more sophisticated data collection and surveillance.

An additional obstacle is the complicated delivery of vaccines expected in Nigeria.  

In April 2020, the NCDC DG announced Nigeria's plans to increase testing to 2 million Nigerians in the following months.  

The NCDC's COVID tracker tested 620,758 specimens as of October 2020, approximately 0.32% of the Nigerian population.  

If the coronavirus testing capacity in Nigeria shows the expected vaccination capacity, a powerful technique needs to be planned before the COVID-19 vaccines are available.

The DG revealed that the low testing capacity was because of external factors beyond the NCDC's ability to organize and transport test specimens and send results back to Nigerians.  

Covid Vaccine Distribution in Nigeria: The Obstacles

Suppose the delivery of specimens is an obstacle for coronavirus testing. How would the Nigerian government overcome its delivery hurdles for a successful vaccination strategy-especially if a vaccine-like Pfizer needs -70º storage and two doses becomes the most available?

The Nigerian economy took a significant hit because of the coronavirus pandemic; securing the funds to allocate and transmit enough vaccines to Nigeria's ~196 million population will be an uphill battle.  

When COVID-19 vaccines become accessible, inadequate rations are likely to be limited across the globe. As a result, a cost-effective method for the vaccination strategy needs to be developed.  

Several experts have advocated for targeted initial vaccination campaigns, with healthcare workers and ''high risk'' populations prioritized in the first phase of vaccinations.

Given Nigeria's limited census and data collection infrastructure and the time sensitivity of vaccinating the population when the vaccines are available, we also see a problem with electronic medical records (EMR) supporting this vaccination campaign.  

But because of the increase in the number of health care centers adopting EMR, particularly in public centers, this could be an excellent opportunity.  

The BHCF and other primary health care revitalization programs in Nigeria are in the right position to leverage additional funding for improved EMR collection at primary health centers, further supporting the targeted distribution of vaccines coordinated by the NPHCDA.

The Nigerian government's efforts to secure enough coronavirus vaccines for the population and plans for a national vaccination delivery strategy can be optimized using EMR data. This data can cross-reference patients with high-risk conditions and identify centers treating a high proportion of COVID-19 patients to target the most vulnerable healthcare workers.

To effectively control the coronavirus pandemic, public and private health centers in Nigeria should embrace technology solutions to leverage EMR data to support a cost-effective vaccination strategy.

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