On a recent weekday, community health worker Hajiya Balkisu Yahaya bared her arm and felt the small prick of the needle as she got her first dose of the COVID-19 vaccine from a colleague. In return, Hajiya Balkisu vaccinated her colleague too. The two are health workers deployed as vaccination teams to immunise against the COVID-19 disease in Nigeria’s Jigawa State and are some of the first to get the jab. 

“I have taken the first dose and I am now very very happy,” Hajiya Balkisu, who works at the Sakwaya Primary Healthcare Center in Dutse, the capital, said. “It’s good so I can protect myself first before protecting others.”

Only two weeks into the arrival of Covid-19 vaccines in Nigeria, Jigawa state, is recording impressive results as authorities accelerate efforts to distribute doses of the AstraZeneca vaccine, millions of which are available across Nigeria. The  vaccines  were delivered to the country from the Serum Institute of India(SII) in early March.

Jigawa has the second-highest turnout for the vaccine, second only to Lagos State. Authorities here received 68,520 doses of the Oxford/AstraZeneca vaccine and 33,508 persons have been vaccinated by March 29. The state has recorded 518 of the 162,593 COVID-19 cases in Nigeria by the same date. 

Hajiya Balkisu says the turn out signifies some vaccination success despite instances of Covid-19 vaccine hesitancy among some residents. 

Since the start of the pandemic last year, unfounded theories about the origin of COVID-19 as well as rumours about the vaccine’s safety  have spread widely across the internet and social media space in Nigeria. Some of them spread claims of vaccines causing infertility in women while others have claimed that vaccines will be administered to the country’s political elite only. 

But working with local communities, the state has overcome a huge part of the fear, state officials note. Getting Jigawa’s residents to turn out was possible largely due to the influence of traditional and religious leaders, according to Mr Hassan Shaibu Kwallam, the State Immunization Officer.

“Our strategy has been a very simple one. We have the buy-in of the local health workers and we also have the cooperation of the traditional leaders. That has made the vaccination process go smoothly.”

When it was time for His Royal Highness, the Emir of Hadejia to get his first jab on a recent Monday, he did it publicly, opting to take the vaccine at the Hadejia General Hospital in the Hadejia Local Government Area (LGA) where many in his community could see. After the Emir received the injection, he held up his green vaccine card,with a QR code stamped on it, for proof.

“I hope to dispel the rumours that a different vaccine, safer and more potent, is being administered to only very important personalities,” the Emir said. “Coming out like this will build trust and confidence in the minds of many that harbour this misconception and will lead to a higher turn-out for vaccine rollout. I am sure of it.”

Partnerships work

It’s not the first time Jigawa has successfully immunized thousands despite some pockets of hesitancy, health authorities say. When the Polio disease was endemic in Nigeria and parents were reluctant to get their wards vaccinated, health workers also turned to traditional and religious leaders for advocacy support. This culminated in the huge success recorded in 2020 when Nigeria was declared polio-free after years of fighting the disease.

Alhaji Ahmed Mohammed Sani, Emir of Gumel who received his vaccine last Wednesday says partnerships between local leaders and health workers increase chances of success when it comes to immunisation.

 “I am presenting my humble self for the COVID-19 vaccination before all so everybody can do the same,” the Emir said. “What we, as an emirate had successfully done during the polio eradication initiative, is a clear testimony of our sustained ability to convince our communities in support of any public health interventions brought up by the government.”

Only health workers like Hajiya Balkisu and traditional leaders were targeted for the first phase of the roll-out, to protect health personnel and build trust among communities. Now, phase two (which targets adults aged 50 and older) and then phase three (for ages between 18 and 49) are due to have commenced. Those who successfully receive their first jabs are expected to take their second doses after 12 weeks.

Nigeria received  3.9 million vaccines in March out of an expected 84 million doses through the COVAX Facility, co-led by Gavi, the Vaccine Alliance, WHO and the Coalition for Epidemic Preparedness Innovations(CEPI), in partnership with the United Nations Children’s Fund, the World Bank, and other partners. COVAX is one pillar of the Access to COVID-19 Tools (ACT) Accelerator, a global collaboration to hasten production and fair access to COVID-19 tests, treatments and vaccines. 

An additional 41.3 million vaccine doses through the Africa vaccine acquisition task team(AVATT) and the African Union are expected in April.

No need for fear

Back in Jigawa, Hajiya Balkisu said she has had to convince many that the slight fever some feel after taking the vaccine was normal - she felt it too and it went away in a day, she added.

Dr Sunday Audu, WHO Jigawa state coordinator echoed her message. “There is no reason for hesitancy,” he urged. “There have been no reports of any serious Adverse Effect Following Immunization (AEFI) in the state. It is only a minor inconvenience but it would be beneficial for more people to get their doses so we can protect ourselves and our neighbours.”

WHO has supported in training the 162 vaccination teams deployed across the 27 LGAs of Jigawa, including Hajiya Balkisu’s team. WHO technical officers, Dr Audu promised, will continue supporting the coordination, training, monitoring and supervision of health care workers till all doses are used up.

“I will advise my colleagues and everyone else to put their mind at rest,” Hajiya Balkisu added as she attended to people waiting to be vaccinated. “Don’t think too much about the inconvenience of the jab. Just relax and you will be fine. It’s much less painful than contracting Covid-19 and falling sick.”