NPHCDA Immunization FHIR IG, published by https://nphcda.gov.ng. This guide is not an authorized publication; it is the continuous build for version 0.9.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/Nigeria-FHIR-Community/NPHCDA-ImmunizationIG/ and changes regularly. See the Directory of published versions

Health Interventions and Recommendations

The interventions referenced in this Digital Adaptation Kit (DAK) are based on Nigeria's National Immunization Schedule and the World Health Organization's Universal Health Coverage list of essential interventions.

This DAK focuses on childhood routine immunization in Nigeria and describes the interventions, service-delivery activities, and recommended practices that should be supported by digital immunization systems.

General Vaccine Administration Practices

General vaccine administration practices for eligible clients, including children, include:

• Counselling on the vaccine or vaccines to be administered, including the delivery of an appropriate health talk.
• Documentation of vaccinations received, including entries recorded on the Child Health Card.
• Documentation and reporting of immunizations administered.
• Observation for adverse events following immunization (AEFI).
• Targeted history-taking and physical examination before vaccination, where appropriate.
• Identification and tracking of clients who have defaulted from the immunization schedule.
• Scheduling and completion of follow-up visits.

Nigeria Routine Immunization Schedule

The following vaccines and related interventions are included in Nigeria's routine childhood immunization schedule.

Minimum Target Age	Vaccine or Intervention	Dosage	Route of Administration	Administration Site
At birth	BCG	0.05 mL	Intradermal	Left upper arm
	OPV 0	2 drops	Oral	Mouth
	Hepatitis B birth dose	0.5 mL	Intramuscular	Anterolateral aspect of the right thigh
6 weeks	Pentavalent 1 (DPT, Hepatitis B, and Hib)	0.5 mL	Intramuscular	Anterolateral aspect of the left thigh
	Pneumococcal Conjugate Vaccine 1	0.5 mL	Intramuscular	Anterolateral aspect of the right thigh
	OPV 1	2 drops	Oral	Mouth
	Rotavirus Vaccine 1	5 drops	Oral	Mouth
	IPV 1	0.5 mL	Intramuscular	Anterolateral aspect of the right thigh, at least 2.5 cm from the PCV injection site
10 weeks	Pentavalent 2 (DPT, Hepatitis B, and Hib)	0.5 mL	Intramuscular	Anterolateral aspect of the left thigh
	Pneumococcal Conjugate Vaccine 2	0.5 mL	Intramuscular	Anterolateral aspect of the right thigh
	OPV 2	2 drops	Oral	Mouth
	Rotavirus Vaccine 2	5 drops	Oral	Mouth
14 weeks	Pentavalent 3 (DPT, Hepatitis B, and Hib)	0.5 mL	Intramuscular	Anterolateral aspect of the left thigh
	Pneumococcal Conjugate Vaccine 3	0.5 mL	Intramuscular	Anterolateral aspect of the right thigh
	OPV 3	2 drops	Oral	Mouth
	Rotavirus Vaccine 3	5 drops	Oral	Mouth
	IPV 2	0.5 mL	Intramuscular	Anterolateral aspect of the right thigh, at least 2.5 cm from the PCV injection site
5 months	Malaria Vaccine 1	0.5 mL	Intramuscular	Deltoid region
6 months	Vitamin A, first dose	100,000 IU	Oral	Mouth
	Malaria Vaccine 2	0.5 mL	Intramuscular	Deltoid region
7 months	Malaria Vaccine 3	0.5 mL	Intramuscular	Deltoid region
9 months	Measles-Containing Vaccine, first dose (MCV1)	0.5 mL	Subcutaneous	Left upper arm
	Yellow Fever Vaccine	0.5 mL	Subcutaneous	Right upper arm
	Meningitis Vaccine	0.5 mL	Intramuscular	Anterolateral aspect of the left thigh
12 months	Vitamin A, second dose	200,000 IU	Oral	Mouth
15 months	Measles-Containing Vaccine, second dose (MCV2)	0.5 mL	Subcutaneous	Left upper arm
	Malaria Vaccine 4	0.5 mL	Intramuscular	Deltoid region
9 years	Human Papillomavirus Vaccine (HPV)	0.5 mL	Intramuscular	Deltoid muscle of the upper arm

Timing Notes

• BCG should preferably be administered within two weeks of birth but may be administered up to 11 months of age.
• OPV 0 should be administered before the child reaches two weeks of age.
• The hepatitis B birth dose should be administered within 24 hours of delivery.

Scope note: This DAK includes content for childhood routine immunization in Nigeria. Non-routine adult vaccination and vaccination campaigns are outside its current scope.

Nigeria and Global Guidelines, Recommendations, and Guidance

The interventions described in this DAK draw primarily from Nigeria's national immunization policies, schedules, guidelines, registers, reporting tools, and programme recommendations. Where a relevant recommendation is not explicitly defined for Nigeria, applicable WHO guidance is used as the default reference.

The following documents and resources informed this DAK:

1. WHO recommendations for routine immunization.
2. Nigeria Immunization Schedule.
3. Basic Guide on Routine Immunization for Service Providers in Nigeria.
4. Draft National Immunization Policy.
5. Child Health Immunization Card.
6. Immunization registers used in Nigeria.
7. Immunization tally sheets used in Nigeria.
8. National Vaccine Policy.
9. Nigeria Strategy for Immunization and Primary Health Care System Strengthening, 2018–2028.
10. Nigeria National Digital Health Information for Immunization and Primary Health Care Roadmap, 2023–2027.
11. Surveillance of Adverse Events Following Immunization: Field Guide, 2011.

Intended Audience and Reading Suggestions

The intended audience for this document includes:

• Business analysts.
• Routine immunization programme managers.
• Software developers and solution architects.
• Digital health implementers.
• Monitoring and evaluation personnel.
• Quality-assurance and conformance-testing teams.
• Trainers and other project personnel responsible for designing or adapting digital immunization workflows in Nigeria.

This document is intended to provide a clear description of Nigeria's routine immunization business processes and recommended interventions for use in the development, configuration, upgrade, maintenance, testing, and training of digital immunization systems.

Readers designing or evaluating a digital solution should use this page together with the DAK sections covering personas, user scenarios, business processes and workflows, decision-support logic, functional requirements, and non-functional requirements. Collectively, these sections define the expected system behaviour and provide a basis for verifying that an implemented solution functions as intended.

See the complete Digital Adaptation Kit (DAK) here