Published in November 2006, this 105-page resource describes the work of a team of community physicians and medical consultants drawn from Nigeria's Bayero University Kano and the Ahmadu Bello University Zaria who were commissioned by the National Programme on Immunization (NPI) to undertake a study on knowledge, perceptions, and beliefs about childhood immunisation and attitudes towards uptake of poliomyelitis immunisation in 11 states of northern Nigeria that are known to be high-risk areas for the transmission of poliomyelitis infection. The team collected information on awareness of the usefulness of vaccines in disease prevention, other measures perceived as preventive against diseases, perception on whether immunisation carries unwanted effects, level of acceptance of immunisation, and reasons for acceptance or rejection of poliomyelitis vaccine.
Selected findings include:
- In most of the 11 states, high figures of respondents were recorded when asked about protective properties of poliomyelitis vaccine.
- Very high figures were recorded of respondents who would accept their children to be vaccinated - with a range of 93.8% in Kaduna state to 80.2% in Zamfara state.
- For those that accept polio vaccine, reasons given include: polio vaccine protects against the disease, my husband accepts the vaccine, it doesn't transmit HIV as was claimed, not against my religion, it doesn't cause sterility as was rumoured, and I don’t believe the negative things said against the vaccine.
- The proportion of respondents who rejected polio vaccine ranged from 6.0% in Kebbi to 20.0% in Zamfara state. Kano, Jigawa, Sokoto, and Bauchi states had rejection rates of more than 15.0% each. For those who reject polio vaccine, reasons given include: children develop polio even after the vaccination, fear of side effect, I have no faith in the vaccine, I don't feel my child needs it, the vaccine contains HIV, contains contraceptives, and is contrary to my religion.
- "The poliomyelitis vaccine, especially doses administered during supplemental immunization activities are particularly detested. The most important reason for this is the misconception that it is a ploy by outsiders (enemies of Islam) to reduce the Muslim population through fortification of the vaccine with contraceptives. Another popular rumour making rounds is the purposeful spread of the HIV virus through the vaccine, which respondents claimed is another way of reducing the population of Muslims. The lack of a clear position on immunization in the religion of Islam is also not helping matters. Another reason found for rejection of immunization particularly polio immunization include the apparent disparity between felt needs of the people and the health care system. Respondents felt solutions should be found to malaria, acute respiratory infections and other visibly more prevalent illnesses including malnutrition rather than concentrating on poliomyelitis. Other reasons given include side effects observed following previous immunizations..."
Recommendations listed include:
- "There is a need to intensify Public health education on the vaccine preventable diseases using radio programmes. Emphasis should be paid to poliomyelitis, the wrong perception on its aetiology, its association with infertility and HIV/AIDS should be dispelled.
- The National Programme on Immunization must ensure availability of all vaccines at all times...
- All components of immunization should be free...
- Since men are the major decision-makers for childhood immunization, male participation in the planning, implementation and evaluation of immunization services is very essential.
- There is the need for NPI to conduct periodic dialogue with Islamic religious leaders on the education of their followers who reject immunization services in the study area.
- The possibility of including immunization programmes in the UBE [Universal Basic Education] curriculum should be considered. This will cultivate a positive attitude towards immunization among children - the future parents/caregivers.
- There must be periodic capacity building for immunization personnel on client-oriented care, injection safety and other relevant skills.
- As rejection is commoner with polio vaccine during house-to-house campaign, this strategy should be de-emphasized. Routine immunization strategy should be accorded the highest level of priority..."