Global childhood immunization coverage has stagnated, with 2.7 million additional children under-vaccinated compared to pre-pandemic levels in 2019, according to the latest data from the World Health Organization (WHO) and the United Nations Children’s Fund (UNICEF).
The 2023 WHO and UNICEF estimates, which provide the world’s largest and most comprehensive dataset on immunization trends for 14 diseases, underscore the urgent need for ongoing catch-up, recovery, and system-strengthening efforts.
The data reveals that the number of children who received three doses of the diphtheria, tetanus, and pertussis (DTP) vaccine—a key marker for global immunization coverage—stalled at 84% (108 million).
UNICEF Executive Director Catherine Russell emphasized the necessity of a global effort to close the immunization gap. “Closing the immunization gap requires a global effort, with governments, partners, and local leaders investing in primary healthcare and community workers to ensure every child gets vaccinated, and that overall healthcare is strengthened,” she said.
Alarmingly, the number of children who did not receive a single dose of the DTP vaccine increased from 13.9 million in 2022 to 14.5 million in 2023.
More than half of these unvaccinated children live in 31 countries with fragile, conflict-affected, and vulnerable settings, where disruptions and lack of access to security, nutrition, and health services exacerbate the risk of preventable diseases.
Additionally, 6.5 million children did not complete their third dose of the DTP vaccine, necessary for achieving disease protection in infancy and early childhood.
These trends highlight ongoing challenges such as disruptions in healthcare services, logistical challenges, vaccine hesitancy, and inequities in access to services, keeping global immunization coverage below 2019 levels.
Vaccination rates against measles also remain a concern, with nearly 35 million children left with no or only partial protection. Only 83% of children worldwide received their first dose of the measles vaccine through routine health services in 2023, and while the number receiving their second dose increased modestly, it still reached only 74%.
“These figures fall short of the 95% coverage needed to prevent outbreaks, avert unnecessary disease and deaths, and achieve measles elimination goals,” WHO stated. Measles outbreaks over the past five years affected 103 countries, home to roughly three-quarters of the world’s infants, primarily due to low vaccine coverage.
Dr. Tedros Ghebreyesus, WHO Director-General, emphasized the solvability of this issue. “Measles outbreaks are the canary in the coal mine, exposing and exploiting gaps in immunization and hitting the most vulnerable first. This is a solvable problem.
The measles vaccine is cheap and can be delivered even in the most difficult places. WHO is committed to working with all our partners to support countries to close these gaps and protect the most at-risk children as quickly as possible,” he said.
Despite these challenges, the data also highlighted some positive trends. The introduction of new and under-utilized vaccines, such as those for human papillomavirus (HPV), meningitis, pneumococcal disease, polio, and rotavirus, continues to expand protection, particularly in the 57 countries supported by Gavi, the Vaccine Alliance.
For instance, the share of adolescent girls globally who received at least one dose of the HPV vaccine, which protects against cervical cancer, increased from 20% in 2022 to 27% in 2023. This increase was driven largely by strong introductions in Gavi-supported countries, including Bangladesh, Indonesia, and Nigeria. The use of the single-dose HPV vaccine schedule also helped boost coverage.
Dr. Sania Nishtar, CEO of Gavi, noted the significant progress in HPV vaccine coverage. “The HPV vaccine is one of the most impactful vaccines in Gavi’s portfolio, and it is incredibly heartening that it is now reaching more girls than ever before. With vaccines now available to over 50% of eligible girls in African countries, we have much work to be done, but today we can see we have a clear pathway to eliminating this terrible disease,” she said.
