New data from UNICEF and the World Health Organization show that while zero-dose children numbers are falling, high drop-out rates for measles vaccines continue to fuel disease outbreaks.
RT’s Three Key Takeaways:
- Stagnant Immunization Progress: While global coverage for the diphtheria, tetanus, and pertussis vaccine rose by 1% in 2025, overall rates remain below 2019 levels and have hovered in a narrow range for over a decade.
- Measles Outbreak Risks: Global measles vaccination coverage remains significantly below the 95% threshold required for herd immunity, leading to large or disruptive outbreaks in 57 countries during 2025.
- Impact of Conflict and Hesitancy: More than half of children who have not received any vaccines live in fragile or conflict-affected settings, while middle- and high-income countries face declining coverage due to shifting political commitment and vaccine hesitancy.
Global childhood vaccination coverage saw a slight increase in 2025, yet remains below pre-pandemic levels, according to the annual World Health Organization-UNICEF Estimates of National Immunization Coverage (WUENIC) released today.
In 2025, 90% of infants globally—nearly 116 million—received at least one dose of the diphtheria, tetanus, and pertussis (DTP) vaccine, and 85% completed the full three-dose series. While both indicators rose by one percentage point from the previous year, global coverage remains one point below 2019 levels, according to the report.
An estimated 13.5 million “zero-dose” children did not receive a single vaccine in their first year during 2025. While this represents nearly 750,000 fewer children than the previous year, progress was offset by a rising number of children who start the schedule but do not complete it. Most of these children live in countries where national immunization programs receive support from Gavi, the Vaccine Alliance.
Measles Coverage and Outbreak Risks
Globally, 7.3 million infants are estimated to have received their first DTP dose but dropped out before receiving their first measles dose. This drop-out rate contributed to stalled measles coverage, with 84% of children receiving the first measles dose and 77% receiving the second dose. Both figures fall short of the 95% threshold required to prevent outbreaks of the contagious virus. Consequently, 57 countries reported large or disruptive measles outbreaks in 2025, according to the data.
“Governments and healthcare workers have helped global vaccination rates bounce back after dropping significantly during the COVID-19 pandemic,” said Catherine Russell, executive director, UNICEF, in a news release. “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% coverage with three doses of the DTP vaccine since 2019. 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.
Regional Performance and Challenges
Compared to 2019 baselines, the Americas and South-East Asia have fully recovered and improved their performance, with South-East Asia now the highest performing region. While Africa, the Eastern Mediterranean, and Europe saw gains last year, their coverage remains below pre-pandemic levels. By contrast, the Western Pacific experienced a decline.
More than half of all zero-dose children live in fragile, conflict-affected, or vulnerable (FCV) settings, even though they account for only about a third of the world’s child population. In these areas, immunization programs are often strained by political upheaval, insecurity, or chronic underfunding. For example, Syria lost 6 percentage points on DTP coverage in a single year, while Sudan recorded the largest single-country gain globally last year despite ongoing conflict.
In middle- and high-income countries, coverage is slipping amid shifting political commitment, structural challenges, or rising hesitancy. South Africa’s DTP coverage has fallen 20 percentage points since 2019, and Bosnia and Herzegovina saw a 23-point drop in measles coverage in the past year.
“Every child, whether born into wealth or poverty, peace or conflict, deserves the lifegiving protection that vaccines provide,” said Dr Tedros Adhanom Ghebreyesus, director-general, WHO, in a news release. “Our greatest security begins with ensuring that everyone, wherever they may live, is protected from deadly diseases that vaccines have the power to prevent.”
Strains on Healthcare Infrastructure
The foundations that enabled progress are under significant strain, according to the agencies. The full impact of cuts to international healthcare financing announced over the past two years is not yet reflected in these estimates, but the data systems needed to track that impact are showing strain.
According to the report, 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. WHO and UNICEF warn that weakening investments in the data systems needed to find and reach children missing out on vaccines will lead to preventable outbreaks and deaths.
UNICEF/WHO Call to Action
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 fragile settings to reach and retain children;
- Counter false and misleading health information and fully support vaccine uptake acceleration;
- Increase and sustain domestic and global funding for immunization programmes and partnerships, including Gavi.
- Invest in stronger data and disease surveillance systems to drive and guide high-impact immunization programme strengthening efforts.
