Nigeria officially launched its malaria vaccination campaign this week to protect millions of children from the deadly disease, focusing heavily on high-risk states.

The first 846,000 doses of the R21 malaria vaccine arrived in Abuja, Nigeria, on Thursday, marking a milestone in efforts to eliminate malaria. According to the World Health Organization, the country accounts for about 27% of global malaria cases. In 2022, it recorded nearly 67 million infections and nearly 200,000 deaths, about 80% of the deaths occurring in children under age 5.

Dr. Muyi Aina, head of the National Primary Health Care Development Agency, said the initial rollout prioritizes high-risk regions.

“We expect another 140,000 or so to make a million doses in this first batch,” Aina said. “Every child, every person that is vaccinated, needs to get two doses. So, we know that that’s a limited number of people. So, we have prioritized the highest-burden locations in the country, Kebbi and Bayelsa.”

The government is covering part of the vaccine costs, with global vaccine group Gavi and international partners funding the rest.

Health Minister Muhammad Pate stressed that the vaccine will be administered to recipients at no charge.

“These vaccines are free for [the] population, but they cost resources,” he said.

Not everyone would be able to afford the vaccines, Pate said.

“The children of the poor in rural areas are the ones that may not be able to access them,” he said. “That’s why we’ve prioritized public financing in that regard, and we thank our partners for contributing toward it.”

Nigeria has improved vaccine logistics for hard-to-reach regions.

UNICEF’s chief of health in Nigeria, Dr. Eduardo Celades, expressed confidence in the country’s distribution capacity.

“Transportation and storage [are] a key issue,” he said. “How [can you] ensure that the cold chain has the integrity needed to keep safe the vaccines and to keep them effective? But we are confident that we know that we have the capacities.”

Malaria remains a complex challenge, requiring a mix of strategies such as mosquito control, better health care access and vaccine monitoring.

Malaria elimination strategic adviser Olugbenga Mokuolu said the vaccine complements traditional tools such as bed nets and treatments, offering children added protection.

“We know that no single tool offers 100% of the solution,” Mokuolu said. “That’s why we still talk about the combination of tools. But having the vaccine layering on it is very significant. … With the deployment of this vaccine, we will be conducting … an effectiveness study in order to note the rate of reoccurrence while on the vaccine.”

The WHO approved the RTS,S and R21 vaccines, with R21 showing 77% efficacy in trials. Other African countries, including Uganda and Burkina Faso, have begun vaccine distribution, reflecting the continent’s push to combat malaria.

Experts say the success of the malaria rollout depends on sustained engagement with local leaders and caregivers to ensure children complete their doses.