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The Big Catch-up implementation in Nigeria

The Big Catch-up was a global initiative launched by Immunization Agenda 2030 partners in April 2023 to close immunity gaps caused by backsliding of immunization coverage during the COVID-19 pandemic, while supporting recovery and acceleration of progress. The Goal was to reach and vaccinate un-immunized and under-immunized children up to at least five years of age. The specific objectives were to

1
Catch up on children missed during 2019–2022 (in part due to pandemic) and provide all missing vaccinations.
2
Restore vaccination coverage rates for the current birth cohort to at least pre-pandemic levels.
3
Strengthen systems within PHC approaches, to improve programme resilience and accelerate towards reaching ZD children in line with IA2030 and Gavi 5.1 goals and targets.

The Big Catchup was implemented in 200 prioritized LGAs across 30 states and the FCT shown in the map below in three rounds of intensified activities with at least 4 weeks in between each each round.  Over 3 million under five children were targeted to be reached in 3 rounds of intensification activities across the identified LGAs.  

Strategies for the Big Catchup

The strategy adopted for the Big Catchup in each of the identified LGA was determined by the level of insecurity in these LGAs which affected accessibility. Based on this, the LGAs were categorised into three groups

1
Fully accessible LGAs. These groups of LGAs are 100 percent accessible with no security threat. Eighty-eight LGAs fall into this category. The strategy adopted in these LGAs was identification and vaccination of eligible children using intensified routine strategies (fixed, outreach and mobile)
2
Partially accessible LGAs. This category of LGAs were 31 to 99 percent accessible. Ninety-four LGAs were in this category. The reaching every settlement strategy (RES) was adopted in these LGAs
3
Inaccessible LGAs. This category of LGAs were below 30 percent accessible and are highly security compromised LGAs. The reaching Inaccessible Children (RIC) Strategy was deployed in these LGAs with the use strict use of military and other specialized security teams as the vaccination teams

Antigens administered during the Big Catchup

The following antigens were prioritized and administered during the Big Catch-up implementation

1
All RI antigen: These were made available for use at the fixed post to reach children 0-23 months. This category of eligible children received the antigens they were due for according to their RI schedule
2
Pentavalent Vaccine: This was administered to children 24 to 59 months old in a 2-dose schedule
3
PCV: This was administered to children 24 to 59 months old in a 1 dose schedule
4
IPV: This was administered to children 24 to 59 months old in a 2-dose schedule
5
bOPV: This was administered to children 24 to 59 months old in a 3-dose schedule

Results of the Big catch-up intervention

By the end of the intervention, these numbers of eligible children have been vaccinated with the following antigens. This intervention has contributed immensely to the reduction in the number of the zero-dose children in Nigeria:

1
Pentavalent: 6,562,220 doses of the vaccines reached the arms and this equivalent to 73% of the targeted children
2
PCV: 2,67,382 doses of the vaccines reached the arms and this equivalent to 89% of the targeted children
3
IPV: 3,111,58 doses of the vaccines reached the arms and this equivalent to 52% of the targeted children
4
bOPV:4,130,419 doses of the vaccines reached the arms and this equivalent to 68% of the targeted children
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