Routine schedule (National Programme on Immunization)
| Age | Vaccines |
|---|---|
| Birth (within 2 weeks; hepatitis B within 24 hours) | BCG, OPV0, hepatitis B birth dose |
| 6 weeks | OPV1, pentavalent 1 (DTP–HepB–Hib), PCV1, rotavirus 1, IPV1 |
| 10 weeks | OPV2, pentavalent 2, PCV2, rotavirus 2 |
| 14 weeks | OPV3, pentavalent 3, PCV3, rotavirus 3, IPV2 |
| 6 months | Vitamin A (repeated every 6 months to 59 months) |
| 9 months | Measles or measles–rubella 1, yellow fever, meningococcal A conjugate |
| 15 months | Measles or measles–rubella 2 |
| 9–14 years (girls) | HPV |
| Pregnancy and women of childbearing age | Td |
Catch-up rules
- Never restart a series — continue from the last dose given
- Keep at least 4 weeks between doses of the same vaccine
- BCG can be given up to 12 months without a skin test
- Rotavirus: start before 15 weeks and finish by 8 months (check the product's age limits)
- Missed measles at 9 months: give it at the first contact, then the second dose at least 4 weeks later
- Give all due vaccines on the same day at different sites
Contraindications
| True contraindications | Not contraindications |
|---|---|
| Anaphylaxis to a previous dose or a vaccine component | Mild illness, low-grade fever, diarrhoea |
| Live vaccines (BCG, measles, yellow fever, OPV) in severe immunosuppression | Malnutrition — it is a reason to vaccinate |
| BCG in symptomatic HIV infection | Prematurity — vaccinate by chronological age |
| Intussusception history for rotavirus vaccine | Current antibiotics; breastfeeding |
| Yellow fever vaccine under 6 months | Family history of reactions or seizures |
Cold chain
- Most vaccines are stored at 2–8 °C
- OPV can be kept frozen at the central level
- Vaccine vial monitor: discard if the inner square matches or is darker than the outer circle
- Shake test for freeze damage in DTP-containing vaccines
- Reconstituted measles, yellow fever and BCG vials are discarded after 6 hours
Zero-dose children
A zero-dose child has not received any routine vaccine. Children with no first dose of a DTP-containing vaccine (pentavalent 1) are used as the working measure. Nigeria has one of the largest numbers of zero-dose children in the world.
| Causes | Effects |
|---|---|
| Poverty and distance from health facilities | Outbreaks of measles, diphtheria and pertussis |
| Insecurity, conflict and displacement | Loss of herd immunity in the community |
| Vaccine hesitancy, misinformation, religious and cultural objections | Deaths and disability from preventable disease |
| Low maternal education and women's limited autonomy | Wasted public spending on outbreak response |
| Weak supply chains and stock-outs | Children who miss vitamin A, nutrition and other contact services too |
| Hard-to-reach nomadic and riverine communities | Re-importation risk for eradicated diseases such as polio |
Remedies: community mapping and outreach, engaging traditional and religious leaders, integrating vaccination with other services, defaulter tracing, reliable vaccine supply, and female education.
Examiner questions
References
- Kliegman RM, St Geme JW, Blum NJ, Tasker RC, Wilson KM, et al., eds. Nelson Textbook of Pediatrics. 22nd ed. Philadelphia: Elsevier; 2025.
- National Primary Health Care Development Agency. National routine immunization schedule. Abuja: NPHCDA.
- World Health Organization. Summary of WHO position papers: recommendations for routine immunization (summary tables, updated periodically). Geneva: WHO.