In 2025, 90% of infants globally – or nearly 116 million – received at least one dose of a diphtheria, tetanus and pertussis (DTP) vaccine, and 85% – 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 – hovering within the same narrow range since 2009.
According to the data, an estimated 13.5 million “zero-dose” children did not receive a single vaccine in their first year during 2025. While these represent nearly 750 000 fewer children than the previous year, progress is offset by a rising number of children who start the schedule and do not complete it. Most of these children live in countries where national immunization programmes receive support from Gavi, the Vaccine Alliance.
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 (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.
“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% 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).
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.
Behind these global and regional averages are persistent threats that are driving variability and volatility in country-level vaccination coverage.
More than half of all zero-dose children live in FCV settings, even though they account for only about a 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 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.
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 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.
“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.”
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%. For example, 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. “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.”
However, the foundations that enabled 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 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.
WHO and UNICEF are working with Gavi, the Vaccine Alliance 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.
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; and
- invest in stronger data and disease surveillance systems to drive and guide high-impact immunization programme strengthening efforts.
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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.
Facts Only
* In 2025, 90% of infants globally received at least one DTP vaccine, or nearly 116 million children.
* 85% of infants globally completed the full three-dose series for DTP vaccines in 2025, or 110 million children.
* Global coverage remains one point below 2019 levels and has been within the same range since 2009.
* An estimated 13.5 million "zero-dose" children did not receive a vaccine in their first year during 2025.
* 7.3 million infants received their first DTP dose but dropped out before receiving their first measles dose.
* Measles coverage saw 84% of children receiving the first measles dose (MCV1) and 77% receiving the second dose (MCV2).
* 57 countries reported large or disruptive measles outbreaks in 2025.
* 100 countries have maintained at least 90% coverage with three doses of DTP since 2019.
* South-East Asia is the highest performing region compared to the Americas and South-East Asia, which fully recovered.
* In fragile settings, Syria lost 6 percentage points on DTP1 coverage and 12 points on MCV1 in a single year.
* Sudan increased DTP1 coverage by 35 percentage points and MCV1 coverage by 22 points in one year.
Executive Summary
Global immunization coverage for DTP vaccines in 2025 reached 90% among infants, with 85% completing the full three-dose series. While these indicators increased by one percentage point from the previous year, global coverage remains one point below 2019 levels, fluctuating within the same narrow range since 2009. An estimated 13.5 million children received no vaccines in their first year during 2025. Progress is complicated by rising numbers of children who begin vaccination schedules but do not complete them, with many residing in areas supported by Gavi, the Vaccine Alliance.
A significant issue exists regarding measles coverage: 7.3 million infants received the first DTP dose but dropped out before receiving the first measles dose. This dropout rate has resulted in stalled measles coverage, as only 84% of children received the first measles dose (MCV1) and 77% received the second dose (MCV2), falling below the necessary 95% threshold to prevent outbreaks. This situation contributed to large or disruptive measles outbreaks in 57 countries in 2025.
Regional performance varied, with the Americas and South-East Asia showing recovery and improvement relative to 2019 baselines, making South-East Asia the highest-performing region. Conversely, Africa, the Eastern Mediterranean, and Europe saw gains but remain below pre-COVID-19 levels. Persistent threats, including conflict, displacement, and poverty, drive volatility in country-level coverage. In fragile settings, such as Syria, coverage on DTP1 decreased while Sudan achieved a significant gain in DTP1 and MCV1 coverage during the same period.
Full Take
The data reveals a systemic tension between global recovery momentum and localized vulnerability, highlighting that aggregated statistics mask profound disparities caused by underlying structural instability. The fact that global coverage is still below 2019 levels, despite rebound efforts post-pandemic, suggests that progress is not linear but dependent on context—specifically the presence of conflict and underfunding. The data points toward a divergence: while some regions demonstrate successful recovery (South-East Asia), others, particularly in conflict-affected areas or middle-income countries facing political shifts, experience regression, underscoring that vaccine access is less about global supply and more about governance and security.
The persistence of zero-dose children in Fragile, Conflict-Affected, or Vulnerable (FCV) settings, where immunization programs are most strained by insecurity or underfunding, indicates that the failure points are socio-political rather than purely logistical. The data concerning Sudan demonstrates that localized improvements in access can occur even amidst conflict, which challenges narratives that assume instability entirely prevents positive movement. Furthermore, the strain on data systems—with only 18 national immunization surveys completed recently—introduces a significant epistemic gap: the ability to accurately track needs and guide interventions is itself compromised. This creates a feedback loop where insufficient investment in surveillance exacerbates outbreaks, which further erodes public trust needed for uptake. The ultimate implication is that achieving equity in childhood health requires not just funding vaccines but simultaneously addressing the root causes of insecurity, political commitment, and systemic data infrastructure deficits across all regions.
Bridge Questions: If the primary barrier to closing the gap to 2019 levels is the lack of robust data systems, what specific investment strategies can rapidly rebuild these surveillance capacities in volatile settings? How can international partners shift focus from simply tracking coverage numbers to actively building resilience against geopolitical and conflict-related disruptions that impede immunization delivery? What mechanisms are needed to ensure that measured progress translates directly into sustained protection for the most vulnerable zero-dose populations, irrespective of local political volatility?
Sentinel — Human
This analysis is highly contextual, drawing detailed links between immunization statistics, geopolitical factors, and systemic data collection weaknesses, indicating sophisticated human-driven journalistic synthesis.
