Journal of Disease and Global Health

COVID‑19 vaccination in Nigeria has been investigated through administrative reports, household and telephone surveys, facility-based studies, qualitative enquiries and digital interventions. Their findings are difficult to reconcile because willingness, hesitancy, receipt of a first dose and completion of vaccination are frequently treated as interchangeable outcomes. This critical narrative review examines the distribution of vaccine uptake, its associated factors and the strength of evidence supporting strategies to improve equitable vaccination. Live searches of publicly accessible scholarly records, web-indexed biomedical literature and authoritative institutional sources identified relevant publications from January 2020 to 22 July 2026, supplemented by foundational methodological and behavioural literature. Evidence was organised by outcome definition, fieldwork period, population, sampling design and inferential strength rather than combined into a pooled national estimate. Early household evidence documented low receipt despite substantial willingness in some populations, whereas later administrative reports indicated considerable expansion of vaccination. These observations do not establish a uniform trajectory across states or population groups. Confidence in vaccine safety, perceived need, trusted recommendations, social endorsement and practical access repeatedly appeared relevant, but demographic associations varied across settings. Most determinant studies were cross-sectional and could not establish whether knowledge, trust or healthcare contact preceded vaccination. Particular uncertainties concern pregnant women, older people outside clinical services, residents of informal settlements and populations poorly represented in telephone or online samples. Nigerian randomised social-media experiments did not demonstrate statistically clear increases in uptake, despite more encouraging observational campaign findings. Evidence from a trial in another West African country supports testing accessible delivery models but does not establish their Nigerian effect size. The most defensible response combines reliable local services with respectful communication, product- and time-specific measurement, and targeted protection of people at higher clinical risk. Future research should prioritise representative longitudinal surveillance, verified vaccination outcomes and pragmatic evaluations that distinguish demand constraints from service failures.