A narrative review of determinants consequences, and public health implications of vaccine hesitancy in Nigeria

Abstract

Vaccine hesitancy remains a significant barrier to achieving optimal immunisation coverage in Nigeria, contributing to recurrent outbreaks of vaccine-preventable diseases and limiting progress towards national and global public health goals. This narrative review synthesises recent evidence on the prevalence, determinants, consequences, and public health implications of vaccine hesitancy in Nigeria, with emphasis on routine childhood immunisation and COVID-19 vaccines. A structured literature search of electronic databases, including PubMed, Google Scholar, Scopus, Frontiers, BMJ Open, Nature, MDPI, and ResearchGate, identified 15 eligible studies published between 2020 and 2025. The evidence was synthesised using thematic analysis. Findings indicate that vaccine hesitancy is influenced by multiple interrelated factors, including socio-cultural and religious beliefs, misinformation and conspiracy theories, limited trust in government and healthcare institutions, concerns regarding vaccine safety and effectiveness, and structural barriers such as poor access to vaccination services. Reported levels of vaccine hesitancy varied considerably across studies because of differences in study populations, vaccine types, geographical settings, and measurement approaches. Historical events, particularly the 2003–2004 polio vaccine boycott, continue to influence vaccine confidence in parts of the country. The review highlights the importance of context-specific interventions, including community engagement, culturally appropriate risk communication, strengthened health systems, and active involvement of healthcare workers and community leaders in promoting vaccine confidence. Overall, the available evidence suggests that vaccine hesitancy remains an important public health challenge in Nigeria and underscores the need for coordinated, evidence-informed strategies to improve vaccine acceptance and strengthen immunisation programmes.