Sentinel analysis of post-vaccine thrombotic thrombocytopenia and serious AEFIs during Nigeria’s Phase I COVID-19 immunization rollout

Title : Sentinel analysis of post-vaccine thrombotic thrombocytopenia and serious AEFIs during Nigeria’s Phase I COVID-19 immunization rollout

Abstract:

Background: In high-burden settings like Nigeria, maternal Hepatitis B Virus (HBV) and Human Immunodeficiency Virus (HIV) infections pose serious risks to pregnancy outcomes and neonatal health. Both are blood-borne, vaccine-preventable diseases with overlapping transmission routes, yet their co-infection dynamics remain underreported in routine antenatal care. This study reveals overlooked HBV-HIV co-infection risks among Nigeria’s pregnant women using real-world primary health center data an essential insight for shaping equitable immunization policies in underserved populations.

Methods: This retrospective cohort analysis reviewed screening records of 1,497 pregnant women registered for antenatal care at a comprehensive urban primary health facility in Lagos, Nigeria (May 2017–February 2020). HBV and HIV rapid diagnostic kits were employed. Demographic and behavioral correlates including age, marital status, education, employment, sexual history, and transfusion status—were statistically tested using SPSS v20 (p<0.05).

Results: HBV prevalence was 4.2%, HIV 3.2%, and dual HBV-HIV co-infection 0.6%. HBV was highest among younger women (25–29 years), while HIV incidence peaked in older age groups (40–45 years). Most infected individuals were married, had low education levels, were self-employed, and reported multiple sexual partners. Co-infected cases, though rare, exhibited overlapping risk profiles and underscored diagnostic blind spots in antenatal screening frameworks.

Conclusion: Findings reflect intermediate HBV endemicity and a hidden maternal co-infection burden. Integrated screening policies for HBV and HIV at all primary health centers are imperative. Strategic interventions—birth-dose HBV vaccination, immunoglobulin availability, and targeted risk education—must be prioritized to eliminate vertical transmission and align with WHO’s 2030 elimination goals.

Keywords: HBV, HIV, Co-infection, Antenatal Care, Nigeria, Pregnant Women, Immunization Equity

Biography:

Dr. Oluwatosin Onasanya is a seasoned public health physician and epidemiologist with over 15 years’ experience in infectious disease surveillance and health system strengthening. Currently serving as Director/Child Health Coordinator at Lagos State Ministry of Health, she collaborates with global partners including WHO, UNICEF, and AFENET.  PhD candidate, she has published in PLOS ONE and IJID, and her work on COVID-19, malaria modeling, and age-friendly systems has earned 360+ citations. Committed to building resilient public health infrastructure and advancing vaccine pharmacovigilance across Africa. Her work informs global health policy and regional capacity building.