In a new report, the World Health Organization (WHO) and the United Nations Children's Fund (UNICEF) said global childhood immunization coverage has stagnated, leaving around 2.7 million children unvaccinated or under-vaccinated.
This is according to the latest WHO-UNICEF estimates on national immunization coverage (WUENIC), published by WHO on its website on Monday.
UNICEF Executive Director Catherine Russell said global efforts are needed to close the immunization gap.
“The latest trends show that many countries are still missing too many children. Closing the vaccination gap requires a global effort, with governments, partners and local leaders investing in primary health care and community workers to ensure that all children are vaccinated and overall health care is strengthened,” she said.
Data
According to the new findings, the number of children who received three doses of diphtheria, tetanus and pertussis (DTP) vaccine – a key indicator of global immunization coverage – remained stagnant at 84 percent (108 million) in 2023.
However, he noted that the number of children who have not received a single dose of the vaccine increased from 13.9 million in 2022 to 14.5 million in 2023.
In fragile and conflict-affected countries, more than 50 percent of unvaccinated children lack access to necessities such as health care, nutrition and safety, leaving them highly vulnerable to preventable diseases, the report found.
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In addition, 6.5 million children did not receive the third dose of the DTP vaccine, which is crucial for protection against diseases in infancy and early childhood.
Global agencies said the stagnation in global immunization coverage since 2022 and failure to return to 2019 levels is a cause for concern, adding that it highlights persistent challenges posed by disruptions to health care services, logistical issues, vaccine hesitancy and unequal access to services.
Recurrence of measles outbreaks
According to data, measles vaccination rates have stagnated, resulting in approximately 35 million children lacking full or no protection against the potentially deadly disease.
Global measles vaccination rates in 2023 fell short of the 95 percent coverage needed for elimination, with only 83 percent of children receiving their first dose and 74 percent their second dose, leaving a significant gap in protection against preventable outbreaks, illness and deaths, it found.
She noted that between 2018 and 2023, a total of 103 countries, representing approximately 75 percent of the world's child population, were affected by measles outbreaks, stating that these outbreaks were largely attributed to low vaccination coverage (below 80 percent).
In stark contrast, 91 countries with high measles vaccination coverage (over 80 percent) managed to avoid outbreaks, highlighting the critical role that strong vaccination coverage plays in preventing measles transmission.
WHO Director-General Tedros Ghebreyesus said measles outbreaks expose immunization gaps, but vaccines can prevent them.
He said: “Measles outbreaks are the canary in the coal mine, exposing and exploiting gaps in immunisation and affecting the most vulnerable first.
“This is a solvable problem. Measles vaccine is cheap and can be administered even in the most difficult settings. WHO is committed to working with all our partners to help countries close these gaps and protect the most at-risk children as soon as possible.”
Progress recorded
The latest figures also revealed encouraging trends in immunization coverage. The gradual introduction of new and underused vaccines, including those for human papillomavirus (HPV), meningitis, pneumococcal disease, polio and rotavirus, is expanding the reach of protection, particularly in the 57 countries supported by Gavi, the Vaccine Alliance.
They said there has been an increase in the global percentage of adolescents receiving at least one dose of the HPV vaccine, which protects against cervical cancer, from 20 percent in 2022 to 27 percent in 2023.
According to them, this progress was attributed to successful implementations in Gavi-supported countries, notably Bangladesh, Indonesia and Nigeria, and the introduction of a single-dose HPV vaccination schedule, which has contributed to the overall increase in vaccination coverage.
Gavi, the vaccine alliance's chief executive, Sania Nishtar, said the HPV vaccine is reaching more girls than ever before, paving the way to eliminating cervical cancer.
“The HPV vaccine is one of the highest-impact vaccines in Gavi’s portfolio, and it is incredibly encouraging that it is now reaching more girls than ever before.
“Now that vaccines are available to more than 50 percent of eligible girls in African countries, we have much work to do, but today we can see that we have a clear path to eliminating this terrible disease,” she said.
They said that while HPV vaccine coverage has increased, it remains far below the 90 percent target needed to eliminate cervical cancer as a public health problem.
In high-income countries, coverage is 56 percent, while in low- and middle-income countries it is only 23 percent.
The report revealed that a recent survey of more than 400,000 users on UNICEF’s U-Report platform revealed alarming gaps in awareness, with 75 per cent of respondents unaware or unsure about HPV.
However, when informed about the virus and its link to cancer, 52 percent expressed interest in receiving the vaccine. Unfortunately, financial constraints (cited by 41 percent) and lack of availability (34 percent) are major barriers to accessing the vaccine.
Local action is essential
According to them, despite modest progress in certain regions, including Africa and low-income countries, the latest estimates underline the urgent need to intensify efforts to achieve the goals of the 2030 Immunization Agenda.
These goals include achieving 90% vaccination coverage and reducing the number of “zero-dose” children worldwide to no more than 6.5 million by 2030.
The report notes that to achieve this, the IA2030 Partnership Council advocated for increased investment in innovation and sustained collaboration.
They also urged partners to strengthen their support for country-led initiatives that integrate routine immunization into comprehensive primary health care programmes supported by strong political commitment, community engagement and sustainable financing.