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Impact of Yellow Fever Vaccination Campaigns on Yellow Fever Vaccination Uptake among Adults in Nigeria

Abstract

Yellow fever remains an important vaccine-preventable public health concern in Nigeria, particularly because transmission can occur in areas where mosquito vectors and susceptible populations coexist. Although yellow fever vaccination is an effective strategy for preventing infection and reducing the risk of outbreaks, vaccination uptake among adults may be affected by inadequate awareness, misconceptions about vaccine safety and effectiveness, low perceived susceptibility, limited knowledge of vaccination recommendations, accessibility barriers, financial constraints, and concerns about adverse effects. Yellow fever vaccination campaigns provide an opportunity to increase public awareness, address misinformation, communicate the benefits of vaccination, and improve access to vaccination services. Effective campaigns may therefore contribute to increased vaccination uptake and strengthen population protection against yellow fever. Against this background, this study investigates the impact of yellow fever vaccination campaigns on yellow fever vaccination uptake among adults in Nigeria. The study will be anchored on the Health Belief Model, Theory of Planned Behavior, and Social Ecological Model. The Health Belief Model explains how adults' perceptions of susceptibility to yellow fever, perceived severity of the disease, perceived benefits of vaccination, perceived barriers, and cues to action may influence vaccination behaviour. The Theory of Planned Behavior emphasizes attitudes toward vaccination, subjective norms, perceived behavioural control, and behavioural intentions as determinants of vaccination uptake. The Social Ecological Model highlights the influence of individual, interpersonal, community, healthcare, and environmental factors on access to and utilization of vaccination services. Collectively, these theoretical perspectives provide a suitable framework for explaining how yellow fever vaccination campaigns may influence vaccination uptake among adults in Nigeria. The study will adopt a quantitative quasi-experimental or analytical cross-sectional research design. The study population will comprise adults aged 18 years and above residing in selected urban, semi-urban, and rural communities across Nigeria. A multistage sampling technique will be used to select geopolitical zones, states, local government areas, communities, households, and eligible adults. Yellow fever vaccination campaigns will be assessed using indicators such as campaign frequency and duration, exposure to vaccination messages, campaign communication channels, community mobilization activities, interpersonal communication, social-media messaging, radio and television messages, information on yellow fever transmission and symptoms, vaccine benefits and safety, vaccination eligibility, campaign locations, accessibility of vaccination points, reminders, and involvement of community leaders or health workers. Yellow fever vaccination uptake will be assessed using indicators such as receipt of yellow fever vaccination, documented vaccination status where available, attendance at campaign vaccination points, vaccination completion where applicable, intention to receive vaccination, and verified vaccination records or vaccination cards where available. Data will be collected using structured questionnaires, vaccination cards or certificates where available, vaccination registers, campaign attendance records, healthcare-facility records, and relevant public health programme documents. Descriptive statistics will be used to summarize participants' characteristics, exposure to vaccination campaigns, knowledge of yellow fever, vaccination attitudes, and vaccination uptake. Inferential statistical techniques, including chi-square tests, t-tests, correlation analysis, and logistic or multiple regression analysis where appropriate, will be used to determine the impact of yellow fever vaccination campaigns on vaccination uptake. Where a quasi-experimental design is adopted, vaccination uptake before and after implementation of the campaign may be compared with that of a comparison community or group to determine changes associated with the intervention. Diagnostic tests will also be conducted to assess the reliability, validity, and robustness of the findings. The study is expected to find that yellow fever vaccination campaigns have a significant positive impact on yellow fever vaccination uptake among adults in Nigeria. Adults exposed to well-organized vaccination campaigns are expected to demonstrate greater awareness of yellow fever and a higher likelihood of receiving vaccination than adults without comparable exposure. Campaign activities may improve knowledge of yellow fever transmission, symptoms, prevention, disease severity, and vaccine benefits while addressing misconceptions and concerns regarding vaccine safety. Community-based mobilization may also encourage adults to attend vaccination points and reduce informational and geographical barriers to vaccination. However, limited vaccine availability, inadequate campaign coverage, financial and transportation barriers, misinformation, low perceived susceptibility, concerns about adverse effects, poor communication, and insufficient follow-up may reduce campaign effectiveness. The study therefore expects accessible, evidence-based, culturally appropriate, and well-coordinated yellow fever vaccination campaigns, supported by reliable vaccination services, to contribute significantly to improved yellow fever vaccination uptake among adults in Nigeria. The study is expected to contribute to the literature on yellow fever prevention, vaccination campaigns, vaccine uptake, infectious disease prevention, health education, adult immunization, community health, and public health in Nigeria. The findings will provide useful information to the Federal Ministry of Health and Social Welfare, Nigeria Centre for Disease Control and Prevention, National Primary Health Care Development Agency, state ministries of health, local government health authorities, primary healthcare centres, healthcare workers, community health workers, community leaders, development partners, and policymakers regarding strategies for strengthening yellow fever prevention and vaccination programmes. The study will also provide evidence-based recommendations for expanding adult yellow fever vaccination campaigns, strengthening community mobilization, improving vaccine accessibility, addressing vaccine misinformation, integrating vaccination education into primary healthcare services, improving campaign monitoring and documentation, and establishing effective follow-up systems to increase vaccination uptake across Nigeria.

Keywords: Yellow fever vaccination campaigns, yellow fever vaccination uptake, yellow fever prevention, adult vaccination, vaccine uptake, infectious disease prevention, health education, community mobilization, immunization, Nigeria, public health.