Janet Ogundepo
The World Health Organisation and United Nations Children’s Fund have said that about 13.5 million infants did not receive a single vaccine in their first year of life despite global childhood immunisation coverage recording modest gains in 2025.
The United Nations agencies also warned that despite a drop of nearly 750,000 in the number of “zero-dose” children compared to the previous year, rising numbers of children who begin but fail to complete their vaccination schedules continue to threaten global efforts to prevent disease outbreaks.
According to the latest WHO-UNICEF Estimates of National Immunisation Coverage released on Tuesday, 90 per cent of infants globally, representing nearly 116 million children, received at least one dose of the diphtheria, tetanus and pertussis vaccine, DPT, in 2025, while 85 per cent, or about 110 million infants, completed the recommended three-dose series.
The report noted that although both indicators increased by one percentage point compared to 2024, global vaccination coverage remains below pre-COVID-19 pandemic levels recorded in 2019 and has remained largely stagnant for more than a decade.
The agencies revealed that an estimated 13.5 million children received no vaccines at all during their first year of life in 2025.
They explained that while the number of zero-dose children declined by nearly 750,000 from the previous year, progress was undermined by a growing number of children who started immunisation but failed to complete the schedule.
The report also showed that an estimated 7.3 million infants received the first dose of the DTP vaccine but did not go on to receive their first measles vaccine.
The agencies warned that this contributed to stalled measles vaccination coverage, with only 84 per cent of children receiving the first measles-containing vaccine dose and 77 per cent receiving the second dose, both well below the 95 per cent coverage needed to prevent outbreaks.
As a result, 57 countries experienced large or disruptive measles outbreaks in 2025.
Already, Nigeria bears the world’s highest burden of unvaccinated children, with more than two million children yet to receive a single dose of any routine vaccine, UNICEF said in 2025.
The WHO Director-General, Dr Tedros Adhanom Ghebreyesus, stressed that vaccines remain one of the most effective public health interventions.
“Every child, whether born into wealth or poverty, peace or conflict, deserves the lifesaving protection that vaccines provide.
“Immunisation is one of the most cost-effective, most equitable, and most reliable interventions for protecting children’s health and well-being.
“Our greatest security begins with ensuring that everyone, wherever they may live, is protected from deadly diseases that vaccines have the power to prevent,” he said.
The UNICEF Executive Director, Catherine Russell, said although vaccination rates had recovered from the sharp declines recorded during the COVID-19 pandemic, millions of children remained unreached.
“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. 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,” Russell said.
The report showed that 100 countries have maintained at least 90 per cent coverage with three doses of the DTP vaccine since 2019.
However, among countries that were below that threshold before the pandemic, only 30 have improved their performance over the past six years, while 65 countries have either stagnated or experienced declining coverage, including 13 fragile, conflict-affected or vulnerable countries.
Regionally, the Americas and South-East Asia have recovered to or exceeded their pre-pandemic vaccination levels, with South-East Asia emerging as the highest-performing region.
Although Africa, the Eastern Mediterranean and Europe recorded improvements last year, vaccination coverage in those regions remains below 2019 levels, while the Western Pacific region experienced further declines.
The agencies said more than half of the world’s zero-dose children live in fragile, conflict-affected and vulnerable settings despite accounting for only about one-third of the global child population.
According to the report, immunisation programmes in these settings continue to struggle because of insecurity, political instability and chronic underfunding.
It cited Syria, where DTP1 coverage dropped by six percentage points and measles vaccine coverage fell by 12 percentage points in one year.
In contrast, Sudan recorded the world’s largest improvement in vaccination coverage in 2025, increasing first-dose DTP coverage by 35 percentage points and first-dose measles vaccine coverage by 22 percentage points.
The report also noted that vaccine hesitancy and declining political commitment are affecting immunisation even in wealthier countries.
For instance, South Africa’s first-dose DTP coverage has fallen by 20 percentage points since 2019 and continued to decline in 2025, while Bosnia and Herzegovina recorded a 23-point decline in first-dose measles vaccination after making substantial gains in 2024.
The agencies noted that sustained investments over the past 25 years have reduced the number of zero-dose children globally by 40 per cent, with countries supported by Gavi, the Vaccine Alliance, now achieving an average 74 per cent coverage across the full schedule of WHO-recommended vaccines.
Chief Executive Officer of Gavi, Dr Sania Nishtar, said the gains demonstrate what is possible through global collaboration but warned that funding challenges could threaten future progress.
“The historic levels of immunisation that we are seeing across lower-income countries show what can be achieved when all stakeholders work together towards a shared objective.
“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 immunisation,” she said.
WHO and UNICEF also warned that recent cuts in international health financing are beginning to weaken immunisation monitoring systems.
They noted that only 18 national immunisation surveys were conducted and submitted in 2025, compared with 50 in 2024, warning that weakening surveillance systems could make it harder to identify children who miss vaccinations and increase the risk of preventable disease outbreaks and deaths.
The agencies called on governments and development partners to strengthen immunisation services in fragile settings, tackle vaccine misinformation, increase domestic and international funding for vaccination programmes, and invest in stronger disease surveillance and data systems to keep global immunisation efforts on track.
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