In 2025, 90% of infants worldwide – or nearly 116 million – received at least one dose of diphtheria, tetanus and pertussis (DTP) vaccine, and 85% – or 110 million – completed the full three-dose series, according to WHO-UNICEF annual estimates published today (WUENICver).
While both indicators are up one percentage point from the previous year, global coverage remains one point below 2019 levels – fluctuating in 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 in 2025. While this represents nearly 750,000 fewer children than the previous year, the progress is offset by the increasing number of children who start the program and do not complete it. Most of these children live in countries where national vaccination programs receive support from Gavi, the Vaccine Alliance.
Worldwide, an estimated 7.3 million infants received their first dose of DTP but abandoned it before receiving their first dose of measles. This dropout rate contributed to delayed measles coverage with 84% of children receiving the first measles dose (MCV1) and 77% receiving the second dose (MCV2). Both figures fall well short of the 95% threshold needed to prevent outbreaks of this highly contagious virus. Consequently, 57 countries reported major or troublesome measles outbreaks in 2025.
Governments and health workers have helped global vaccination rates recover after a significant drop during the COVID-19 pandemic. But millions of vulnerable children are still left unprotected due to conflict, displacement and poverty. We need to reach every child and we need to rebuild trust where it breaks down. No child should suffer from a disease that a simple vaccine can prevent.”
Catherine Russell, UNICEF Executive Director
Data from 195 countries show that 100 countries have maintained at least 90% coverage with three doses of DTP vaccine as of 2019, with little progress in expanding this group. Of the countries below 90% coverage in 2019, 30 have improved their rates over the past six years, but 65 remain stagnant or lagging behind, including 13 fragile, conflict-affected or vulnerable countries (FCVs).
Compared to their 2019 baselines, the Americas and Southeast Asia have fully recovered and improved their performance, with the latter now the highest performing region. While the African, Eastern Mediterranean and European regions showed gains last year, their coverage remains below pre-Pandemic levels of COVID-19. In contrast, the Western Pacific declined, leaving it the region below the 2019 baseline.
Behind these global and regional averages lie persistent threats that cause variability and instability in vaccination coverage at the country level.
More than half of zero-dose children live in FCV environments, even though they represent only about one-third of the world’s child population. In these settings, vaccination programs are often constrained by political unrest, insecurity, or chronic underfunding. For example, in a single year, Syria lost 6 percentage points in DTP1 coverage and 12 points in MCV1. However, Sudan recorded the largest single country gain globally last year, increasing DTP1 coverage by 35 percentage points and increasing MCV1 coverage by 22 points, demonstrating what is possible when access to services improves even in the midst of ongoing conflict.
In middle- and high-income countries, even where vaccines are fully accessible, coverage is slipping amid changing political commitment, structural challenges, or growing reluctance. For example, South Africa’s DTP1 coverage declined by 20 percentage points from 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 percentage point drop last year.
“Every child, whether born into wealth or poverty, peace or conflict, deserves the life-giving protection that vaccines provide. Immunization is one of the most cost-effective, most equitable and most reliable interventions to protect children’s health and well-being,” said Dr Tedros Adhanom Ghebreyesus, WHO Director-General.
Over the past 25 years, continued investment by governments and partners, community commitments, strengthened programs and widespread public trust have reduced the annual number of zero-dose children by 40%. For example, in Gavi-supported countries, children today are protected against more diseases than ever before, with 74% average coverage today in a full range of WHO-recommended vaccines.
“The historic immunization levels we are seeing in lower-income countries show what can be achieved when all stakeholders work together towards a common goal,” said Dr Sania Nishtar, CEO of Gavi, the Vaccine Alliance. “As Gavi heads into a new five-year period, our big challenge now will be to maintain this momentum in the face of funding constraints, geopolitical uncertainty and growing outbreaks – while working harder to reach those children who do not yet have access to vaccination.”
However, the foundations that made progress possible are now under significant strain. The full impact of the cuts in international health funding announced over the past two years is not yet reflected in these estimates, but the data systems needed to monitor this impact and protect against backsliding are under pressure in themselves. According to the data, only 18 national vaccination surveys were conducted and reported this round, up from 50 in 2024 and an average of 33 per year between 2015 and 2019. Weakening investment in the data systems needed to find and reach children who miss vaccines will lead to more cases and deaths that could have been caused.
WHO and UNICEF are working with Gavi, the Vaccine Alliance and other partners to achieve the global Immunization Agenda 2030 (IA2030) goal to ensure that vaccines reach everyone, everywhere, at every age, yet the world is further away from achieving the global goal of reducing childhood immunization to zero.
To make this sharp course correction and bridge the critical gap, WHO and UNICEF are calling on governments and relevant partners to:
- Strengthening immunization in conflict and fragile settings to reach and preserve children;
- combat false and misleading health information and fully support accelerating vaccine uptake;
- increase and sustain domestic and global funding for vaccination programs and partnerships, including Gavi; and
- invest in stronger data and disease surveillance systems to drive and guide efforts to strengthen the high-impact vaccination program.
