Global Immunization Coverage Shows Signs of Recovery, But Millions Remain Unprotected, WUENIC Report Reveals
In 2025, 90% of infants globally – approximately 116 million children – received at least one dose of the diphtheria, tetanus, and pertussis (DTP) vaccine, while 85%, or 110 million, completed the full three-dose series. These figures, released today in the annual WHO-UNICEF Estimates of National Immunization Coverage (WUENIC), indicate a one-percentage-point rise from the previous year. However, global coverage remains a single percentage point below 2019 levels, signifying a prolonged period of stagnation within a narrow range since 2009.
The WUENIC report, a crucial barometer of global public health efforts, highlights a complex picture of progress and persistent challenges in childhood immunization. While the rebound in vaccination rates following the significant disruptions caused by the COVID-19 pandemic is a cause for cautious optimism, the findings underscore the urgent need to address the millions of children still missing out on life-saving vaccines.
The Persistent Challenge of "Zero-Dose" Children
Despite the overall upward trend, an estimated 13.5 million infants did not receive any vaccine dose in their first year of life during 2025. While this represents a reduction of nearly 750,000 "zero-dose" children compared to the prior year, this positive development is offset by an increasing number of children who initiate the vaccination schedule but do not complete it. A significant proportion of these vulnerable children reside in countries that receive support from Gavi, the Vaccine Alliance, pointing to systemic issues within national immunization programs in these regions.
Furthermore, the data reveals a concerning trend of dropouts after the initial DTP dose. Globally, an estimated 7.3 million infants received their first DTP dose but did not proceed to receive their first measles vaccine. This dropout rate has directly contributed to stalled coverage for measles vaccination. Only 84% of children received the first dose of the measles-containing vaccine (MCV1), and a mere 77% received the second dose (MCV2). These figures fall considerably short of the 95% coverage threshold deemed essential by public health experts to prevent widespread outbreaks of this highly contagious disease. The direct consequence of this gap is evident in the alarming statistic that 57 countries reported large or disruptive measles outbreaks in 2025, underscoring the vulnerability of inadequately vaccinated populations.
Voices of Concern and Commitment
UNICEF Executive Director Catherine Russell acknowledged the concerted efforts that have led to the recovery in global vaccination rates. "Governments and health workers have helped global vaccination rates bounce back after dropping significantly during the COVID-19 pandemic," she stated. However, she also sounded a grave warning: "But millions of vulnerable children are still being left unprotected due to conflict, displacement, and poverty. We must reach every child, and we must rebuild trust where it is fraying. No child should suffer from a disease that a simple vaccine can prevent."
Echoing this sentiment, Dr. Tedros Adhanom Ghebreyesus, WHO Director-General, emphasized the fundamental right of every child to protection. "Every child, whether born into wealth or poverty, peace or conflict, deserves the lifegiving protection that vaccines provide. Immunization is one of the most cost-effective, most equitable, and most reliable interventions for protecting children’s health and well-being," he declared. "Our greatest security begins with ensuring that everyone, wherever they may live, is protected from deadly diseases that vaccines have the power to prevent."
Regional Disparities and Underlying Factors
The WUENIC data, compiled from 195 countries, reveals a mixed regional performance. While 100 countries have maintained at least 90% DTP three-dose coverage since 2019, progress in expanding this group has been slow. Of the countries below the 90% threshold in 2019, only 30 have improved their rates over the past six years, while a significant 65 countries are either stagnating or regressing, including 13 fragile, conflict-affected, or vulnerable (FCV) countries.
Geographically, the Americas and South-East Asia regions have not only fully recovered their pre-pandemic immunization levels but have also shown improved performance, with South-East Asia now emerging as the highest-performing region. While Africa, the Eastern Mediterranean, and Europe regions experienced gains in 2025, their coverage rates still lag behind pre-COVID-19 pandemic levels. Conversely, the Western Pacific region has seen a decline, making it the region furthest below its 2019 baseline.
Beneath these overarching averages lie complex and persistent threats that create variability and volatility in vaccination coverage at the country level.
The Amplified Vulnerability in Fragile and Conflict-Affected Settings
Fragile, conflict-affected, and vulnerable (FCV) settings disproportionately bear the brunt of immunization gaps. More than half of all "zero-dose" children globally reside in these regions, despite accounting for only about a third of the world’s child population. In these contexts, immunization programs are frequently undermined by political instability, ongoing insecurity, or chronic underfunding. The report cites Syria as a stark example, where in a single year, the country experienced a six-percentage-point decline in DTP1 coverage and a 12-point drop in MCV1 coverage.
However, the report also offers a beacon of hope, highlighting Sudan’s remarkable achievement as the largest single-country gain globally in the past year. Sudan’s DTP1 coverage surged by 35 percentage points, with MCV1 coverage increasing by 22 points. This dramatic improvement underscores the potential for rapid gains when access to essential health services is restored, even amidst challenging circumstances.
Challenges in Middle- and High-Income Countries
Intriguingly, even in middle- and high-income countries where vaccine availability is generally not a primary concern, immunization coverage is showing signs of erosion. This decline is attributed to a confluence of factors, including shifting political priorities, structural challenges within health systems, and a concerning rise in vaccine hesitancy. South Africa, for instance, has witnessed a significant 20-percentage-point decrease in DTP1 coverage since 2019, with a continued downward trend observed in 2025. Similarly, Bosnia and Herzegovina, after experiencing the largest increase in MCV1 coverage in its region in 2024, saw a sharp 23-point drop in the past year, illustrating the fragility of immunization gains even in seemingly stable environments.
The Critical Role of Data and Funding
The efficacy of immunization programs hinges on robust data collection and analysis. However, the WUENIC report indicates a worrying decline in the number of national immunization surveys being conducted and submitted. Only 18 such surveys were completed and submitted for the current round, a significant drop from 50 in 2024 and the annual average of 33 between 2015 and 2019. This weakening of the data infrastructure, essential for identifying and reaching unvaccinated children, poses a direct threat, potentially leading to preventable outbreaks and deaths. The full impact of international health financing cuts announced over the past two years is not yet reflected in these estimates, but the strain on data systems is already apparent.
A Collective Effort Towards Immunization Agenda 2030
WHO and UNICEF, in collaboration with Gavi, the Vaccine Alliance, and other partners, are committed to achieving the global Immunization Agenda 2030 (IA2030). This ambitious strategy aims to ensure that vaccines reach everyone, everywhere, at every age. However, the current trajectory suggests that the world is moving further away from the target of significantly reducing the number of zero-dose children.
To rectify this course and bridge the critical gaps, WHO and UNICEF are calling for concerted action from governments and relevant partners. These calls to action, though not detailed in the provided text, are expected to focus on strengthening primary health systems, rebuilding trust in vaccines, addressing barriers to access, and ensuring sustained and adequate funding for immunization programs.
Historical Context and Future Outlook
Over the past 25 years, sustained investments from governments and partners, community engagement, strengthened program implementation, and widespread public trust have led to a remarkable 40% reduction in the annual number of zero-dose children. Countries supported by Gavi, for example, now demonstrate average coverage of 74% across a full course of WHO-recommended vaccines, a testament to what is achievable through collaborative efforts.
Dr. Sania Nishtar, CEO of Gavi, the Vaccine Alliance, highlighted the success of these partnerships. "The historic levels of immunization that we are seeing across lower-income countries show what can be achieved when all stakeholders work together towards a shared objective," she remarked. "As Gavi heads into a new five-year period, our great challenge now will be to maintain this momentum in the face of funding constraints, geopolitical uncertainty, and increasing outbreaks – while working harder to reach those children that still do not have access to immunization."
The current strain on the foundations that enabled past progress, coupled with potential future funding cuts, presents a formidable challenge. The agencies warn that a weakening of investment in data systems crucial for identifying and reaching underserved children will inevitably lead to an increase in preventable outbreaks and deaths.
Conclusion
The WUENIC report serves as a critical reminder that while progress in global immunization is being made, the fight against preventable childhood diseases is far from over. The gains observed in 2025 are encouraging but fragile, threatened by ongoing conflicts, displacement, poverty, and in some contexts, declining political commitment and rising hesitancy. Reaching every child with life-saving vaccines requires sustained global commitment, innovative solutions, and a renewed focus on equity and accessibility, ensuring that no child is left behind in the pursuit of a healthy future.
Notes to Editors:
Multimedia content is available for download at https://weshare.unicef.org/package/2AMZIFM6BA5H.
The WHO dataset can be accessed via the Global dashboard, country profiles, and additional resources at https://immunizationdata.who.int/, https://worldhealthorg.shinyapps.io/wuenic-trends, and https://www.who.int/teams/immunization-vaccines-and-biologicals/immunization-analysis-and-insights/global-monitoring/immunization-coverage/who-unicef-estimates-of-national-immunization-coverage respectively.
The UNICEF dataset is available through an overview page, full datasets, data visualization, regional data visualization, and country profiles at https://data.unicef.org/topic/child-health/immunization/, https://data.unicef.org/resources/dataset/immunization/, https://data.unicef.org/resources/immunization-coverage-estimates-data-visualization/, https://data.unicef.org/resources/regional-immunization-snapshots/, and https://data.unicef.org/resources/immunization-country-profiles/ respectively.
WUENIC estimates, including historical data, are revised annually as new country data become available. Figures in this release should not be compared against previous years’ published reports.
Based on country-reported data, the WHO and UNICEF estimates of national immunization coverage (WUENIC) provide the world’s largest and most comprehensive dataset on immunization trends for vaccinations against 13 diseases given through regular health systems – normally at clinics, community centres, outreach services, or health worker visits. For 2025, data were provided from 185 countries.
WHO and UNICEF are working with Gavi, the Vaccine Alliance, and other partners to deliver the global Immunization Agenda 2030 (IA2030), a strategy for all countries and relevant global partners to achieve set goals on preventing diseases through immunization and delivering vaccines to everyone, everywhere, at every age.
About UNICEF:
UNICEF, the United Nations agency for children, works to protect the rights of every child, everywhere, especially the most disadvantaged children and in the toughest places to reach. Across more than 190 countries and territories, we do whatever it takes to help children survive, thrive, and fulfil their potential. For more information about UNICEF and its work, please visit: www.unicef.org.
About WHO:
Dedicated to the well-being of all people and guided by science, the World Health Organization leads and champions global efforts to give everyone, everywhere an equal chance at a safe and healthy life. We are the United Nations’ agency for health that connects nations, partners, and people in 150+ locations – leading the world’s response to health emergencies, preventing disease, addressing the root causes of health issues, and expanding access to medicines and health care. Our mission is to support all countries to promote, provide, and protect health. "Together for health. Stand with science," the theme of World Health Day 2026 marks a year-long campaign to highlight science as the foundation for protecting health and well-being worldwide.
