Abstract:

Vaccine hesitancy remains a threat to public health stemming from low trust in health authorities. In Nigeria, historical events show how eroded trust undermines immunization efforts. This study assessed Nigerians’ trust in vaccine regulatory authorities and its relationship with vaccine confidence and uptake A cross-sectional survey of adults (≥18 y) was conducted across all six geopolitical zones. Mixed-mode data collection (60 % interviewer‐administered; 40 % online) yielded 289 valid responses from a stratified national sample. The questionnaire captured demographics, vaccination history, trust in institutions, exposure to misinformation, and confidence indicators. Descriptive statistics, χ² tests and multivariable logistic regression assessed links between trust and vaccination behaviours. Results indicate median age was 31 y; 58 % were women and 91 % had ≥secondary education. Overall, 83 % had been vaccinated previously and 81 % of parents reported fully immunised children. Two-thirds agreed that NAFDAC is competent and 65 % trusted NPHCDA’s programme management, yet only 42 % trusted the government’s general public-health handling. While 74 % believed vaccines greatly improve health, COVID-19 uptake remained low (50 % unvaccinated). High trust in NAFDAC correlated with strictly following recommended schedules (63 % vs 36 %, p<0.001) and higher COVID-19 vaccination (51 % vs 34 %, p<0.05). Trust in regulators independently predicted routine uptake (aOR≈2.2 per trust-scale point, p<0.001). This study noted that moderate trust in Nigerian regulators strongly influences vaccine confidence and real-world uptake. Policymakers should prioritise visible safety monitoring, clear communication and local forums that build institutional trust to boost national immunisation rates.

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