Give families a free month of nutrient sachets at the vaccine clinic, and measles vaccination climbs 20 points

Vaccines only work if children get to them, and in much of the world the trip to the clinic is the hard part: a long walk, a long wait, a day's work lost. Health programmes have tried text reminders, leaflets and small cash payments, mostly with modest results. A trial published in Nature Medicine on 2 October 2026 tested something more tangible. At the end of the vaccine queue, caregivers were handed a month's supply of small-quantity lipid-based nutrient supplements (SQ-LNS): a 20-gram sachet a day of an energy-dense, vitamin- and mineral-fortified paste that the World Health Organization already recommends for children aged 6 to 23 months in food-insecure places.

The trial ran in Nguru and Karasuwa, two mostly rural districts of Yobe State in north-east Nigeria where armed groups, kidnappings and long distances make health care fragile. Before it began, only about three in ten children aged 12 to 23 months had a measles vaccination recorded on a card, and one in seven young children was acutely malnourished. Twenty health areas, each served by one primary health centre, were split by public lottery, held in Hausa in front of village heads: ten got the sachets alongside routine vaccination (the 'NutriVax' strategy) and ten carried on as usual. Both groups had the same community outreach promoting vaccination and child feeding. The sachets were never conditional: a family that turned down a vaccine still went home with them. Between July 2024 and July 2025, the ten centres handed out 3,753,009 sachets to 19,739 children.

To measure the effect, survey teams visited households in May 2024 and again in May 2025, about 1,600 children each time, and counted only measles doses written on a vaccination card. In the comparison areas, card-verified coverage of the first measles dose rose from 29.9% to 41.2%. In the sachet areas it went from 25.0% to 55.3%. After accounting for the starting point, that is a 20.1 percentage-point bigger rise, and roughly double the odds of a child being vaccinated. The gains spread beyond measles: the third dose of the pentavalent vaccine, the meningitis and yellow fever vaccines, the second measles dose, keeping the vaccination card and receiving vitamin A all improved, and the share of 'zero-dose' children, who had never had a single routine shot, fell sharply. All this happened even though only 48% of the children surveyed in the sachet areas had ever received the supplement.

There are limits. It is one trial in one region, it was open-label (everyone knew which areas had sachets), and a humanitarian organisation helped keep supplies flowing, which a stretched health system might not manage. Families in the sachet areas complained more often about long waits. Even with the boost, card-verified measles coverage reached only 55%, far below the 95% with two doses needed to stop outbreaks, and the authors say the sachets alone won't get there. The effect on children's growth and the cost of the programme will be reported separately. Still, compared with earlier attempts to raise vaccine uptake, the size of the jump is unusual, and it suggests that the most persuasive reason to come back to a clinic may be something useful to take home.