The Role of School Engagement in Increasing Vaccination During Measles Mass Vaccination Campaign in Nigeria, 2018: The Lagos State Experience

Abstract
Background: Schools based vaccination provide opportunity for the delivery of routine vaccines, using the school as the venue of delivery. During the 2017/2018 measles vaccination campaign, the school system stakeholders were systematically engaged for buy-in to vaccinate 9-59 months old children in Lagos State, Nigeria. This paper is a report of how the Lagos state school authority were engaged for the 2018 measles vaccination campaign. It also highlights the contribution of the engagement in the overall performance of the state looking at the vaccination coverage data and comparing that with the previous campaign. Method: We reported on the role of engaging the school health system in improving coverage using a descriptive mixed-method study design. The stakeholders cutting across the government, education sector, public and private schools were identified and engaged through coordination meetings, dialogues, lobby and sensitization to support vaccination in schools. We summarized the outcome of the engagement activities, analyzed the administrative, post-campaign coverage data and compared it with the 2016 measles supplemental activities coverage. Results: A total of 12,903 schools were used as venues (vaccination posts), while 22 sensitization meetings were held with school associations. About 80% of all eligible children vaccinated in the Local Government Areas (LGAs) during the 2018 Measles Vaccination Campain (MVC), received the vaccine at schools. The lowest proportion of children vaccinated at school was 45.0% in Oshodi LGA. Surulere LGA had the highest proportion of children vaccinated in schools (95.0%). Overall, Lagos state had a weighted average coverage of 93.8% for the post-campaign coverage survey. Conclusion: The implementation of the school engagement process for supplemental immunization activities contributed to achieving high vaccination coverage as most of the children aged 9-59 months were vaccinated in schools.