As Nigeria struggles with millions of children missing out on life-saving vaccines, pharmacists are calling for a shift in how routine immunisation is delivered, arguing that community pharmacies could help close one of the country’s most stubborn healthcare gaps.

Nigeria currently carries the highest burden of unvaccinated children globally, with more than 2 million children yet to receive a single dose of any routine vaccine, according to the United Nations Children’s Fund. Health experts say this “zero-dose” challenge reflects deeper weaknesses in primary healthcare delivery, especially in communities where health centres are overstretched, underused or simply too far away.

Pharmacists believe they can help change that picture.

Community pharmacies, they argue, are often the most accessible point of care for families, particularly in urban, peri-urban and hard-to-reach areas where primary healthcare centres struggle with staffing and infrastructure gaps. Integrating pharmacies into routine immunisation services, they say, could significantly expand coverage and reduce the number of children left unprotected against preventable childhood diseases.

Speaking on the issue, the immediate past vice chairman of the Pharmaceutical Society of Nigeria in Ogun State, Dr Olumide Obube, said pharmacist-led vaccination, if properly regulated and integrated, could complement existing immunisation programmes rather than replace them.

He noted that a significant proportion of Nigerian children remain unvaccinated, not because vaccines are unavailable, but because access points are limited. “Approximately 31 percent of children aged 12 to 23 months are zero-dose, meaning they have not received any routine vaccination. This figure highlights systemic weaknesses in primary healthcare outreach, particularly in underserved and hard-to-reach communities,” he said.

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Obube said evidence from other settings shows that pharmacists are ready to take on a broader public health role, including immunisation services. He argued that pharmacies are uniquely positioned to improve vaccine access due to their proximity to households, extended operating hours, and the trust many communities already place in pharmacists.

“What this means is that pharmacies should be involved as strategic partners in immunisation services. It should be a deliberate and evidence-based approach that improves vaccine accessibility, coverage, safety, efficiency and equity,” he explained. “Equity here means that children who need vaccines must actually be able to get them.”

He added that low immunisation coverage is also linked to Nigeria’s heavy reliance on out-of-pocket healthcare spending, which discourages families from consistently engaging with the health system. In his view, expanding immunisation points beyond hospitals and primary healthcare centres could help address this reality.

Obube also pointed to the wider pressure facing Nigeria’s health system, noting that hospitals are increasingly overwhelmed by cases that could be handled at the community level. Strengthening the role of community pharmacies, he said, would not only improve immunisation coverage but also ease congestion in secondary and tertiary facilities.

He explained that pharmacists are already being integrated into structured care pathways for conditions such as malaria and HIV through test-and-treat or test-and-refer models. These approaches, he said, promote early diagnosis, improve referrals and reduce pressure on hospitals, provided proper regulation and quality assurance are in place.

However, he stressed that expanding pharmacists’ roles would require deliberate policy action. Regulatory reforms, capacity building and clear integration into the national immunisation framework are essential, he said, warning that without these steps, opportunities to strengthen primary healthcare would continue to be missed.

Similar views have been echoed by the national leadership of the Pharmaceutical Society of Nigeria. The President of the Society, Aliyu Tanko, has previously noted that although primary healthcare centres are meant to be the first point of contact for millions of Nigerians, licensed pharmacists are absent from many of these facilities.

Rather than restricting pharmacists to secondary and tertiary hospitals, Tanko said they should be recognised as key members of the primary healthcare workforce. Full integration of pharmacists into national health programmes, particularly at the primary healthcare and public health levels, he said, remains a core expectation of the Society as the country looks ahead.

For pharmacists, the argument is straightforward. Without innovative, community-based solutions, Nigeria risks leaving millions of children behind. With better regulation, training and integration, they believe pharmacies could play a critical role in protecting children, strengthening disease prevention and easing pressure on an already stretched health system.

Meiza Nigeria