Nearly 750,000 fewer zero-dose children than a year ago, but high drop-out rates continue to threaten progress and increase the risk of disease outbreaks.
In 2025, 90 per cent of infants globally, or nearly 116 million, received at least one dose of a diphtheria, tetanus and pertussis (DTP) vaccine, and 85 per cent, or 110 million, completed the full three-dose series, according to the annual WHO-UNICEF Estimates of National Immunization Coverage (WUENIC) released today.
While both indicators rose by one percentage point from the previous year, global coverage remains one point below 2019 levels and has hovered within the same narrow range since 2009.
Recovery slows in the most fragile countries
According to the data, an estimated 13.5 million zero-dose children did not receive a single vaccine during their first year of life in 2025. While this represents nearly 750,000 fewer children than the previous year, progress is offset by a rising number of children who start the immunization schedule but do not complete it. Most of these children live in countries where national immunization programmes receive support from Gavi, the Vaccine Alliance.
Globally, an estimated 7.3 million infants received their first DTP dose but dropped out before receiving their first measles vaccine. This drop-out rate contributed to stalled measles coverage, with 84 per cent of children receiving the first measles dose (MCV1) and 77 per cent receiving the second dose (MCV2). Both figures remain well below the 95 per cent threshold required to prevent outbreaks of this highly contagious virus. Consequently, 57 countries reported large or disruptive measles outbreaks in 2025.
«Governments and health workers have helped global vaccination rates bounce back after dropping significantly during the COVID-19 pandemic,» said UNICEF Executive Director Catherine Russell. «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.»
Data from 195 countries show that 100 countries have maintained at least 90 per cent coverage with three doses of DTP vaccine since 2019, with little progress in expanding this group. Of the countries below 90 per cent coverage in 2019, 30 improved their rates over the past six years, but 65 countries are stagnating or falling behind, including 13 fragile, conflict-affected or vulnerable countries (FCV).
Compared with their 2019 baselines, the Americas and South-East Asia have fully recovered and improved their performance, with the latter now the highest-performing region. While Africa, the Eastern Mediterranean and Europe recorded gains last year, their coverage remains below pre-COVID-19 pandemic levels. By contrast, the Western Pacific experienced a decline, leaving it the region furthest below its 2019 baseline.
Behind these global and regional averages are persistent threats driving variability and volatility in country-level vaccination coverage.
Investing in immunization to protect progress
More than half of all zero-dose children live in FCV settings, even though they account for only about one third of the world’s child population. In these settings, immunization programmes are often strained by political upheaval, insecurity or chronic underfunding. For example, in a single year, Syria lost 6 percentage points in DTP1 coverage and 12 percentage points in MCV1 coverage. By contrast, Sudan recorded the largest single-country gain globally last year, increasing DTP1 coverage by 35 percentage points and MCV1 coverage by 22 percentage points, demonstrating what is possible when access to services improves even amid ongoing conflict.
In middle- and high-income countries, even where vaccines are fully accessible, coverage is slipping amid shifting political commitment, structural challenges or rising hesitancy. For example, South Africa’s DTP1 coverage has fallen by 20 percentage points since 2019 and continued to decline in 2025. After recording the largest increase in MCV1 coverage in the region in 2024, Bosnia and Herzegovina saw a 23-percentage-point drop over the past 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 for protecting children’s health and well-being,» said Dr Tedros Adhanom Ghebreyesus, WHO Director-General. «Our greatest security begins with ensuring that everyone, wherever they may live, is protected from deadly diseases that vaccines have the power to prevent.»
Over the past 25 years, sustained investments from governments and partners, commitments from communities, strengthened programmes and broad public trust have reduced the annual number of zero-dose children by 40 per cent. In countries supported by Gavi, children today are protected against more diseases than ever before, with an average coverage of 74 per cent across the full course of WHO-recommended vaccines.
«The historic levels of immunization we are seeing across lower-income countries show what can be achieved when all stakeholders work together towards a shared objective,» said Dr Sania Nishtar, CEO of Gavi, the Vaccine Alliance. «As Gavi heads into a new five-year strategic period, our greatest challenge now is to maintain this momentum in the face of funding constraints, geopolitical uncertainty and increasing outbreaks, while working even harder to reach children who still do not have access to immunization.»
Acting now to close the immunization gap
However, the foundations that enabled this progress are now under significant strain. The full impact of cuts to international health financing announced over the past two years is not yet reflected in these estimates, but the data systems needed to track that impact and prevent backsliding are themselves showing signs of strain. According to the data, only 18 national immunization surveys were undertaken and submitted in this reporting round, down from 50 in 2024 and an average of 33 per year between 2015 and 2019. The agencies warn that weakening investments in the data systems needed to identify and reach children who are missing out on vaccines will lead to outbreaks and deaths that could have been prevented.
WHO and UNICEF are working with Gavi, the Vaccine Alliance, and other partners to deliver the Immunization Agenda 2030 (IA2030), the global strategy to ensure that vaccines reach everyone, everywhere and at every age. However, the world is falling further behind in reaching the global target of reducing the number of zero-dose children.
To get back on track and close this critical gap, WHO and UNICEF call on governments and partners to:
- Strengthen immunization programmes in conflict and fragile settings to reach and protect children.
- Counter false and misleading health information and fully support vaccine uptake.
- Increase and sustain domestic and international funding for immunization programmes and partnerships, including Gavi.
- Invest in stronger data and disease surveillance systems to strengthen high-impact immunization programmes and guide decision-making.
