{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T14:57:49Z","timestamp":1791385069379,"version":"4.3.3"},"reference-count":21,"publisher":"American Society of Tropical Medicine and Hygiene","issue":"4","license":[{"start":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T00:00:00Z","timestamp":1791331200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,10,7]]},"abstract":"<jats:title>ABSTRACT.<\/jats:title>\n                  <jats:p>Malaria remains a leading cause of morbidity and mortality in Nigeria, particularly among children under 5 years of age, despite ongoing control efforts. The introduction of RTS,S\/AS01, and R21\/Matrix-M vaccines provides a promising complementary prevention strategy. This systematic review assessed malaria vaccine rollout in Nigeria, focusing on implementation, awareness, acceptance, willingness to pay, and health system readiness. A comprehensive search of PubMed, ScienceDirect, Google Scholar, African Index Medicus, and gray literature (2015\u20132026) identified 12 eligible studies. Caregiver acceptance ranged from 76.6% in Lagos to 95.6% in Owerri, and exceeding 90% in Enugu, Ondo State, and Gombe. Among health care professionals, only 54.1% of pharmacists were willing to vaccinate their children. Caregiver awareness ranged from 9.7% in Lagos to 72.1% in Enugu. Physicians demonstrated higher adequate knowledge (68.9%) than nurses (35.9%), with 55.5% of nurses having only heard of the vaccine. Pharmacists expressed concerns about vaccine failure (53.6%), adverse effects (63.4%), and storage conditions (77.8%). Willingness to pay was moderate; median willingness in Enugu was USD $0.82 per dose; 71.2% of Lagos caregivers expressed willingness to pay; and 90% of respondents nationally preferred government-funded vaccination. Health system readiness was critically inadequate, with overall facility preparedness scores ranging from 33% to 51%. Advocacy and social mobilization were at 0% across all three facilities, and monitoring and supervision ranged from 0% to 33%, all far below the WHO-recommended 95% threshold. Strengthening health systems, targeted communication, and sustainable public financing are essential for a successful nationwide malaria vaccine rollout.<\/jats:p>","DOI":"10.4269\/ajtmh.26-0371","type":"journal-article","created":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T16:50:41Z","timestamp":1787849441000},"page":"702-708","source":"Crossref","is-referenced-by-count":0,"title":["Malaria Vaccine Rollout in Nigeria: Current Status and Challenges"],"prefix":"10.4269","volume":"115","author":[{"given":"Samuel Adeniyi","family":"Oyegbade","sequence":"first","affiliation":[{"name":"Department of Biological Sciences, College of Science and Technology, Covenant University, Ota, Nigeria;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samson Olusola","family":"Adeboye","sequence":"additional","affiliation":[{"name":"Department of Biological Sciences, College of Science and Technology, Covenant University, Ota, Nigeria;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gbotemi Jerry","family":"Oni","sequence":"additional","affiliation":[{"name":"Africa Centre of Excellence for Mycotoxins and Food Safety (ACEMFS), Federal University of Technology, Minna, Nigeria;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abosede Peace","family":"Oyegbade","sequence":"additional","affiliation":[{"name":"Ace Medicare Clinics, Ota, Nigeria;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James Joy","family":"Oziohu","sequence":"additional","affiliation":[{"name":"Department of Biochemistry, University of Ilorin, Ilorin, Nigeria;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zawu Yoowa","family":"Duyann","sequence":"additional","affiliation":[{"name":"Africa Centre of Excellence for Mycotoxins and Food Safety (ACEMFS), Federal University of Technology, Minna, Nigeria;"},{"name":"University of Liberia Fendall Campus, Monrovia, Liberia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oluwatoyin Comfort","family":"Owoyemi","sequence":"additional","affiliation":[{"name":"Div Medical Services and Hospital, Adekunle Fajuyi Cantonment, Ibadan, Nigeria"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2795","reference":[{"key":"b1","article-title":"Malaria.","year":"2025"},{"issue":"1","key":"b2","series-title":"Malar J","first-page":"36","article-title":"Acceptance and affordability of malaria vaccines: Issues relating to hesitancy and willingness to pay amongst Nigerian parents of under-five children","volume":"24","author":"Adigwe","year":"2025"},{"key":"b3","series-title":"Front Cell Infect Microbiol","first-page":"939532","article-title":"Cerebral malaria induced by plasmodium falciparum: Clinical features, pathogenesis, diagnosis, and treatment","volume":"12","author":"Song","year":"2022"},{"key":"b4","series-title":"IJS Glob Health","first-page":"e00577","article-title":"Implementation of malaria vaccine in Nigeria: Challenges and recommendations","volume":"8","author":"Okereke","year":"2025"},{"issue":"10426","key":"b5","series-title":"Lancet","first-page":"533","article-title":"Safety and efficacy of malaria vaccine candidate R21\/Matrix-M in African children: A multicentre, double-blind, randomised, phase 3 trial","volume":"403","author":"Datoo","year":"2024"},{"key":"b6","article-title":"Nigeria Introduces the R21 Vaccine in a Pivotal Move for Malaria Control: WHO Regional Office for Africa.","year":"2024"},{"issue":"3","key":"b7","series-title":"Hum Vaccin Immunother","first-page":"480","article-title":"RTS,S\/AS01 vaccine (Mosquirix\u2122): An overview","volume":"16","author":"Laurens","year":"2020"},{"key":"b8","series-title":"J Clin Epidemiol","first-page":"103","article-title":"Updating guidance for reporting systematic reviews: Development of the PRISMA 2020 statement","volume":"134","author":"Page","year":"2021"},{"key":"b9","series-title":"BMC Public Health","first-page":"154","article-title":"Are healthcare workers\u2019 intentions to vaccinate related to their knowledge, beliefs and attitudes? A systematic review","volume":"13","author":"Herzog","year":"2013"},{"issue":"1","key":"b10","series-title":"Malar J","first-page":"187","article-title":"Awareness, perceptions and intent to comply with the prospective malaria vaccine in parts of South Eastern Nigeria","volume":"17","author":"Chukwuocha","year":"2018"},{"key":"b11","series-title":"Int J Health Promot Educ","first-page":"1","article-title":"Risk perception and hesitancy towards malaria vaccines among hospital pharmacists in southeast Nigeria: A cross-sectional study","author":"Isah","year":"2023"},{"issue":"1","key":"b12","series-title":"Malar J","first-page":"117","article-title":"Willingness to accept malaria vaccines amongst women presenting at outpatient and immunization clinics in Enugu state, Southeast Nigeria","volume":"23","author":"Chinawa","year":"2024"},{"issue":"1","key":"b13","series-title":"BMC Public Health","first-page":"4011","article-title":"Awareness, acceptability, and willingness to pay for the R21\/Matrix-M malaria vaccine: A cross-sectional study among pregnant women and nursing mothers in Enugu State, Nigeria","volume":"25","author":"Dim","year":"2025"},{"issue":"1","key":"b14","series-title":"Discov Public Health","first-page":"312","article-title":"Knowledge, perception and willingness of mothers to accept malaria vaccine for their children in Ondo West Local Government, Ondo State","volume":"22","author":"Andrew","year":"2025"},{"issue":"3","key":"b15","series-title":"Nigeria. J Interv Epidemiol Public Health","first-page":"78","article-title":"Caregivers\u2019 readiness and willingness to accept malaria vaccine for children under five years in Gombe State","volume":"8","author":"Adamu","year":"2025"},{"issue":"1","key":"b16","series-title":"Malar J","first-page":"142","article-title":"Nurses\u2019 knowledge and willingness to recommend malaria vaccination to caregivers of under-5 in Nigeria: A nationwide survey","volume":"24","author":"Adeleke","year":"2025"},{"issue":"1","key":"b17","series-title":"BMC Infect Dis","first-page":"1345","article-title":"Physicians\u2019 knowledge of, and willingness to encourage caregivers to partake in the RTS S\/AS01 and R21 matrix M malaria vaccines roll out\u2014A national survey in Nigeria","volume":"25","author":"Oboh","year":"2025"},{"issue":"4","key":"b18","series-title":"Ibom Med J","first-page":"583","article-title":"Readiness of R21 malaria vaccine introduction in tertiary hospitals in Northern Nigeria","volume":"18","author":"Haruna","year":"2025"},{"issue":"1","key":"b19","series-title":"Malar J","first-page":"135","article-title":"R21\/MATRIX malaria vaccine: Awareness, perception, acceptability, and willingness to pay among caregivers of under-five children in endemic communities in Lagos, Nigeria","volume":"25","author":"Agboola","year":"2026"},{"issue":"6","key":"b20","series-title":"PLOS Glob Public Health","first-page":"e0004387","article-title":"Safety of RTS, S\/AS01E vaccine for malaria in African children aged 5 to 17 months: A systematic review and meta-analysis of randomized controlled trials","volume":"5","author":"Zoa","year":"2025"},{"issue":"4","key":"b21","series-title":"BMJ Glob. Health","first-page":"e014719","article-title":"Policy uptake and implementation of the RTS, S\/AS01 malaria vaccine in sub-Saharan African countries: Status 2 years following the WHO recommendation","volume":"9","author":"Osoro","year":"2024"}],"container-title":["The American Journal of Tropical Medicine and Hygiene"],"original-title":[],"link":[{"URL":"https:\/\/www.ajtmh.org\/view\/journals\/tpmd\/115\/4\/article-p702.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.ajtmh.org\/downloadpdf\/journals\/tpmd\/115\/4\/article-p702.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/www.ajtmh.org\/downloadpdf\/journals\/tpmd\/115\/4\/article-p702.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T14:24:34Z","timestamp":1791383074000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ajtmh.org\/view\/journals\/tpmd\/115\/4\/article-p702.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10,7]]},"references-count":21,"journal-issue":{"issue":"4"},"URL":"https:\/\/doi.org\/10.4269\/ajtmh.26-0371","relation":{},"ISSN":["0002-9637","1476-1645"],"issn-type":[{"value":"0002-9637","type":"print"},{"value":"1476-1645","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10,7]]}}}