Global childhood vaccination coverage advances despite conflict and reluctance – UNICEF, WHO

In 2025, 90% of infants worldwide – or nearly 116 million – received at least one dose of diphtheria, tetanus and pertussis (DTP) vaccine, and 85% – or 110 million – completed the full three-dose series, according to the WHO-UNICEF Annual Estimates of National Immunization Coverage (WUENIC) released today.

While both indicators are up one percentage point year-on-year, global coverage remains one point below 2019 levels – moving within the same narrow range since 2009.

According to the data, an estimated 13.5 million “zero-dose” children did not receive any vaccine in the first year of vaccination during 2025. While this represents nearly 750,000 fewer children than the previous year, the progress is offset by the increasing number of children who start the vaccine and do not complete it. Most of these children live in countries where national immunization programs are supported by Gavi, the Vaccine Alliance.

Globally, an estimated 7.3 million infants received their first dose of DTP but left school before receiving their first measles dose. This drop-out rate contributed to a lag in measles coverage with 84% of children receiving the first measles dose (MCV1) and 77% receiving the second dose (MCV2). Both figures are well below the 95% threshold needed to prevent an outbreak of this highly contagious virus. Consequently, 57 countries reported major or devastating measles outbreaks in 2025.

“Governments and health workers have helped global vaccination rates recover after a significant decline during the COVID-19 pandemic,” said UNICEF Executive Director Catherine Russell. “But millions of vulnerable children still remain unprotected due to conflict, displacement and poverty. We must reach every child and we must rebuild trust where it has been broken. No child should suffer from a disease that a simple vaccine can prevent.”

Data from 195 countries show that 100 countries maintained at least 90% coverage with three doses of the DTP vaccine as of 2019, with little progress in expanding this group. Of the countries below 90% coverage in 2019, 30 have improved their rates over the past six years, but 65 countries are stagnant or lagging behind, including 13 fragile, conflict-affected or vulnerable countries (FCVs).

Compared to the 2019 baseline, the Americas and Southeast Asia have fully recovered and improved their performance, with the latter now the best-performing region. Although the regions of Africa, the Eastern Mediterranean and Europe recorded progress last year, their coverage remains below the levels before the COVID-19 pandemic. In contrast, the Western Pacific experienced a decline, leaving it the region furthest below its 2019 baseline.

Behind these global and regional averages are ongoing threats that drive variability and volatility in vaccination coverage at the country level.

More than half of the children who received a zero dose live in FCV conditions, although they only make up about a third of the world’s child population. In these environments, immunization programs are often plagued by political upheaval, insecurity, or chronic underfunding. For example, in one year Syria lost 6 percentage points on DTP1 coverage and 12 points on MCV1. However, Sudan saw the largest single-country increase globally last year, increasing DTP1 coverage by 35 percentage points and raising MCV1 coverage by 22 points, showing what is possible when access to services improves even in the midst of ongoing conflict.

In middle- and high-income countries, even where vaccines are fully available, coverage is declining due to changing political commitments, structural challenges, or increasing reluctance. For example, South Africa’s DTP1 coverage fell by 20 percentage points from 2019 and continued to decline in 2025. After the region’s largest increase in MCV1 coverage in 2024, Bosnia and Herzegovina saw a 23-point drop last year.

“Every child, whether born into wealth or poverty, peace or conflict, deserves the life-saving protection that vaccines provide. Immunization is one of the most cost-effective, equitable and reliable interventions to protect the health and well-being of children,” said Dr. Tedros Adhanom Ghebreyesus, Director-General of WHO. “Our greatest security begins with ensuring that everyone, wherever they live, is protected from the deadly diseases that vaccines have the power to prevent.”

Over the past 25 years, sustained investment by governments and partners, community commitments, strengthened programs and broad public confidence have reduced the annual number of children exposed to zero doses by 40%. For example, in countries supported by Gavi, children are now protected against more diseases than ever before, with 74% average coverage today with the full cycle of WHO-recommended vaccines.

“The historic levels of immunization we are seeing in lower-income countries show what can be achieved when all stakeholders work together towards a common goal,” said Dr. Sania Nishtar, CEO of Gavi, Vaccine Alliance. “As Gavi enters a new five-year period, our big challenge now will be to maintain this momentum despite funding constraints, geopolitical uncertainty and increasing outbreaks – as we do more to reach those children who still do not have access to immunization.”

However, the foundations that made progress possible are now under great pressure. The full impact of cuts in international health funding announced over the past two years is not yet reflected in these estimates, but the data systems needed to monitor that impact and protect against backsliding are themselves showing strain. According to the data, only 18 national immunization surveys were conducted and reported this round, down from 50 in 2024 and an average of 33 per year between 2015 and 2019. Weakening investments in the data systems needed to find and reach children who are missing vaccines will lead to preventable outbreaks and deaths, the agencies warn.

WHO and UNICEF are working with Gavi, the Vaccine Alliance and other partners to achieve the goal of the Global Immunization Agenda 2030 (IA2030) to ensure that vaccines reach everyone, everywhere, at every age, but the world is still far from achieving the global goal of reducing children to zero doses.

To make this sharp course correction and bridge the critical gap, WHO and UNICEF call on governments and relevant partners to:

• strengthen immunization in conflict and vulnerable settings to reach and retain children;
• oppose false and misleading health information and fully support the acceleration of the use of vaccines;
• increase and sustain domestic and global funding for immunization programs and partnerships, including Gavi; and
• invest in stronger data and disease surveillance systems to drive and guide efforts to strengthen high-impact immunization programs.

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Access to the WHO dataset: Global Dashboard, country profilesand additional funds

Access to the UNICEF dataset: Overview page, Full datasets, Data visualization, Regional data visualization, Country profiles

WUENIC estimates, including historical data, are revised annually as new country data become available. The figures in this press release should not be compared with published reports from previous years.

Based on country-reported data, the World Health Organization and UNICEF Estimates of National Immunization Coverage (WUENIC) provide the largest and most comprehensive set of data on trends in vaccinations against 13 diseases in the world that are given through regular health systems – usually in clinics, community centers, help desks or health worker visits. For the year 2025, data was submitted from 185 countries.

WHO and UNICEF are working with Gavi, the Vaccine Alliance and other partners to implement the Global Immunization Agenda 2030 (IA2030), a strategy for all countries and relevant global partners to achieve disease prevention goals through immunization and vaccine delivery to everyone, everywhere, at every age.

About UNICEF
UNICEF, the United Nations children’s agency, works to protect the rights of every child, everywhere, especially those children in the most disadvantaged positions and in hard-to-reach places. In more than 190 countries and territories, we do what it takes to help children survive, thrive and reach their potential.