Vaccine Preventable Disease: State-Of-The-Art Appraisal of Impact and Challenges Across Fragile, Conflict-Affected and Vulnerable (FCV) Communities in Northern Nigeria

This paper is a Systematic Literature Review (SLR) that appraised the impact of vaccine-preventable diseases (VPDs) and associated immunization challenges in fragile, conflict-affected and vulnerable (FCV) communities of Northern Nigeria. The paper draw on 18 empirical studies published between 2015 and 2025. The papers were sourced through a rigorous PRISMA-guided search across major databases and grey literature. The review synthesizes evidence on three focal areas: the effects of ongoing conflict on vaccination coverage, socio-cultural and logistical barriers to vaccine uptake and strategies employed to improve immunization outcomes challenges in FCV communities. The findings revealed that armed conflicts, particularly the Boko Haram insurgency, substantially disrupt vaccination programmes by damaging healthcare infrastructure, displacing populations and impeding access to routine immunization services. The disruption resulted in marked declines in vaccine coverage and increased outbreak risks. Socio-cultural factors such as misinformation, religious skepticism and low health literacy intensify vaccination hesitancy, while inadequate cold chain facilities and transportation barriers associated with logistic further hinder vaccine delivery. The review showed the promising adaptive strategies including mobile clinics, community engagement leveraging local leaders, targeted health communication campaigns and government-led integrated outreach, which collectively mitigate these challenges and enhance vaccine acceptance. The diverse methodological approaches—quantitative, qualitative and mixed methods—adopted by the included studies ensured a robust understanding of the context-specific barriers and facilitators. This review indicated the necessity of multifaceted, culturally sensitive and contextually tailored interventions combining policy reforms with grassroots participation to improve immunization equity in FCV communities in Northern Nigeria. The evidences synthesized in this review aims to inform policymakers, health practitioners and stakeholders in designing effective, sustainable vaccination programmes amidst persistent insecurity and fragility in fragile, conflict-affected and vulnerable (FCV) communities of Northern Nigeria.

Vaccine Preventable Disease, Vaccine impacts, Vaccines challenges, Fragile