Global Childhood Immunization Rates Stall at 90% DTP Coverage, 13.5 Million Children Remain Zero-Dose in 2025
Key Insights
In 2025, 90% of infants globally received at least one DTP dose, yet coverage remains one point below 2019 levels and has stagnated within a narrow range since 2009.
An estimated 13.5 million "zero-dose" children received no vaccines in their first year, with over half living in fragile, conflict-affected settings.
Measles (search) coverage stalled at 84% for the first dose, far below the 95% threshold needed to prevent outbreaks, with 57 countries reporting large or disruptive measles outbreaks in 2025.
Global childhood immunization coverage remains stalled, with 90% of infants—nearly 116 million—receiving at least one dose of the diphtheria, tetanus and pertussis (DTP) vaccine (search) in 2025, and 85% completing 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.
An estimated 13.5 million "zero-dose" children did not receive a single vaccine in their first year during 2025. Although 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 (search).
"Governments and health workers have helped global vaccination rates bounce back after dropping significantly during the COVID-19 pandemic. But millions of vulnerable children are still being left unprotected due to conflict, displacement, and poverty," said Catherine Russell, UNICEF Executive Director. "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."
Measles (search) coverage falls dangerously short of prevention threshold
Globally, 7.3 million infants are estimated to have received their first DTP dose but dropped out before receiving their first measles (search) dose. This drop-out rate contributed to stalled measles coverage, with 84% of children receiving the first measles dose (MCV1) and 77% receiving the second dose (MCV2). Both figures fall far short of the 95% threshold required to prevent outbreaks of this highly contagious virus. Consequently, 57 countries reported large or disruptive measles outbreaks in 2025.
Regional disparities and conflict-driven volatility
Data from 195 countries show that 100 countries have maintained at least 90% coverage with three doses of DTP vaccine since 2019, with little progress in expanding this group. Of the countries below 90% 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).
More than half of all zero-dose children live in FCV settings, even though these settings account for only about a third of the world's child population. In these environments, immunization programmes are often strained by political upheaval, insecurity, or chronic underfunding. In a single year, Syria lost 6 percentage points on DTP1 coverage and 12 points on MCV1. However, Sudan recorded the largest single-country gain globally last year, increasing DTP1 coverage by 35 percentage points and lifting MCV1 coverage by 22 points, demonstrating what is possible when access to services improves even amid ongoing conflict.
Compared to 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 regions saw 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.
In middle- and high-income countries, even where vaccines are fully accessible, coverage is slipping amid shifting political commitment, structural challenges or rising hesitancy. South Africa's DTP1 coverage has fallen 20 percentage points since 2019 and continued to decline in 2025. After the largest increase in MCV1 coverage in the region in 2024, Bosnia and Herzegovina saw a 23-point drop in the past year.
Financing cuts threaten data systems and future progress
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 protect against backsliding are themselves showing strain. According to the data, only 18 national immunization surveys were undertaken and submitted 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 out on vaccines will lead to outbreaks and deaths that could have been prevented, warn the agencies.
"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," 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."
Progress and the path forward
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%. In countries supported by Gavi, children today are protected against more diseases than ever before, with 74% average coverage today across a full course of WHO-recommended vaccines.
"The historic levels of immunization that we are seeing across lower income countries shows what can be achieved when all stakeholders work together towards a shared objective," said Dr Sania Nishtar, CEO of Gavi, the Vaccine Alliance (search). "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."
Debbie King, Research Lead in Vaccines at Wellcome (search), emphasized the broader context: "In too many countries we are seeing the impact of political instability, conflict and funding cuts on childhood immunisation rates. These are the children who are most at risk, who are not receiving potentially life-saving vaccines."
She added: "Progress is possible. In 2025 Gavi-eligible countries vaccinated more children than ever and over 60% of countries maintained high coverage or are progressing. Yet globally we remain off track to meet the 2030 targets of halving the number of unvaccinated children compared to 2019 and eliminating the transmission of dangerous but preventable diseases like measles (search)."
WHO and UNICEF are working with Gavi, the Vaccine Alliance (search) and other partners to deliver the global Immunization Agenda 2030 (IA2030) goal to ensure vaccines reach everyone, everywhere, at every age, yet the world is further off track to reach the global target of reducing zero-dose children. The agencies call on governments and relevant partners to make a sharp course correction and bridge the critical gap in immunization coverage.