Data-driven, community-led vaccination is reaching the unreached children in Bauchi State, Nigeria

Bauchi, Data-driven, community-led vaccination is enabling children who have never received any vaccines (zero-dose) in Bauchi State to be reached, demonstrating how targeted action can close immunisation gaps at scale.

In Tumfafi Ward, Shira Local Government Area of Bauchi State, Jamila Muhammad approaches a vaccination post, something she had previously avoided. Her decision reflects a wider shift across underserved communities, where integrated, primary health care-based vaccination is reaching children who have not received any routine vaccines.

Closing immunity gaps through government leadership
In early 2026, measles cases in Wuro Bugga highlighted persistent gaps in immunisation coverage. Investigations found that, despite previous measles-rubella campaigns, some children had missed routine vaccines because of caregiver hesitancy and limited access, leaving them vulnerable to preventable diseases.

The Bauchi State Government, through the State Primary Health Care Development Agency, intensified integrated outreach in collaboration with the National Primary Health Care Development Agency, supported by World Health Organization (WHO) and partners, including Gavi, the Vaccine Alliance. The approach aligns with Nigeria's National Strategy for Immunisation and Primary Health Care System Strengthening (NSIPSS), prioritising zero-dose children, equitable coverage and stronger PHC systems whilst advancing the Immunisation Agenda 2030.

"Our priority is to ensure that every child, regardless of location, has access to life-saving vaccines," said Dr Sani Mohammed Dambam, Bauchi State Commissioner for Health. "This approach expands access, rebuilds trust and closes long-standing immunity gaps."

Data to action: targeting missed children
Routine immunisation data highlight persistent disparities. At least 13 local government areas, including Toro, Kirfi, Alkaleri, Ganjuwa, Shira and Ningi, have a high number of zero-dose children, with low pentavalent vaccine (Penta-3) coverage, which protects against five diseases, and many children miss follow-up doses. While overall state coverage is about 79%, nearly 45% LGAs remain below 80%, increasing the risk of vaccine preventable disease outbreaks.
These data-informed, targeted outreach efforts focus on hard-to-reach, nomadic and riverine communities where both access and demand remain low. Microplanning identified missed settlements, enabling teams to prioritize high-risk areas and track zero-dose children more effectively.

Building trust to reduce hesitancy
Hesitancy in these communities is driven by limited access, misinformation and low confidence in health services. To address this, health workers and community mobilizer implemented sustained, community-led engagement.
The teams conducted repeated household visits, engaged religious and traditional leaders, and held dialogues in local languages prioritising listening and consistency over one-off campaigns.

"They didn't rush us. They kept coming back and explaining," Jamila said. "That is what made me change my mind."
Mallam Musa Adamu, a community leader in Tumfafi Ward, described the shift:

"At first, many families refused. Some believed the vaccines were not safe, while others said their children were healthy. When we got involved, we explained the importance during community meetings and mosque gatherings. Now, more parents are bringing their children."

Bringing services closer
To reduce access barriers, the state implemented an integrated delivery model combining routine immunisation for children aged 0-23 months, introduction of the malaria vaccine, and the Big Catch-Up targeting children aged 24-59 months.

Vaccination posts were established closer to communities, including hard-to-reach settlements, reducing travel time and cost.

Across all 20 LGAs, 1,292 health workers were deployed to 323 wards during a four-day malaria vaccination intensification campaign from 24 to 28 March 2026. Results included:
• 5,139 children received routine vaccines
• 105,451 children aged 5-21 months received the first dose of malaria vaccine
• 737 zero-dose children were identified and vaccinated
• 10,929 children aged 24-59 months received pentavalent vaccine doses
• 2,411 girls aged 9 years received the human papillomavirus (HPV) vaccine

Delivering services together reduced missed opportunities and increased uptake within a single visit.

Awareness that drives uptake
For Safiya Yakubu, a caregiver in Zango settlement, personal experience informed her decision to vaccinate her 15-month-old son.
"I once had severe malaria and almost collapsed," she said. "When I heard about the vaccine, I went straight to the health facility. I did not want my child to go through what I experienced."

Frontline health worker Aisha Sani noted a shift in demand:

"Before, we saw fear and resistance. Now caregivers are asking questions and are ready to vaccinate their children. When people understand, they accept."

Within minutes, Jamila's child received life-saving vaccines.

"Before, I was afraid of vaccines. Now I am more afraid of the diseases," she said.

From state progress to national priority

Bauchi's data reflect both progress and remaining gaps. While coverage is improving, zero-dose children persist in underserved communities.

This mirrors the national and global context. Nigeria has one of the highest numbers of zero-dose children globally, with over 2.1 million children who have not received any routine vaccines, largely in hard-to-reach areas. Globally, an estimated 14.3 million children remain unvaccinated each year, sustaining outbreaks of vaccine-preventable diseases.

Reaching these children is central to Nigeria's commitment to Universal Health Coverage and stronger primary health care. Unvaccinated children remain at the highest risk of illness and death and continue to drive transmission.

Sustaining gains
WHO support includes technical guidance, microplanning, training for health workers, and strengthened data used to identify and track zero-dose children. This complements government leadership at both the state and national levels.

Bauchi's experience shows that when data guides action, services are integrated, and communities are engaged, immunisation coverage improves. Sustaining and scaling this approach will be critical to reaching every child and ensuring equitable access to life-saving vaccines.
• WHO Immunization Data Portal: https://immunizationdata.who.int
• NPHCDA: https://nphcda.gov.ng