Global childhood immunization levels stalled in 2023 leaving many without life-saving protection

Global childhood immunization coverage stalled in 2023, leaving 2.7 million additional children un- and under-vaccinated compared to pre-pandemic levels in 2019, according to data published today by the World Health Organization (WHO) and UNICEF.

The latest WHO and UNICEF estimates of national immunization coverage (WUENIC) – which provide the world’s largest and most comprehensive dataset on immunization trends for vaccinations against 14 diseases – underscore the need for ongoing catch-up, recovery and system-strengthening efforts.

“The latest trends demonstrate that many countries continue to miss far too many children,” said UNICEF Executive Director Catherine Russell. “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.”

According to the findings, the number of children who received three doses of the vaccine against diphtheria, tetanus and pertussis (DTP) in 2023 - a key marker for global immunization coverage - stalled at 84% (108 million). However, the number of children who did not receive a single dose of the vaccine increased from 13.9 million in 2022 to 14.5 million in 2023.

More than half of unvaccinated children live in the 31 countries with fragile, conflict-affected and vulnerable settings, where children are especially vulnerable to preventable diseases because of disruptions and lack of access to security, nutrition, and health services.

Additionally, 6.5 million children did not complete their third dose of the DTP vaccine, which is necessary to achieve disease protection in infancy and early childhood.

These trends, which show that global immunization coverage has remained largely unchanged since 2022 and – more alarmingly - has still not returned to 2019 levels, reflect ongoing challenges with disruptions in healthcare services, logistical challenges, vaccine hesitancy and inequities in access to services.

Low vaccine coverage already driving measles outbreaks

The data further show that vaccination rates against the deadly measles disease stalled, leaving nearly 35 million children with no or only partial protection.

In 2023, only 83% of children worldwide received their first dose of the measles vaccine through routine health services, while the number of children receiving their second dose modestly increased from the previous year, reaching 74% of children. These figures fall short of the 95% coverage needed to prevent outbreaks, avert unnecessary disease and deaths, and achieve measles elimination goals.

Over the last five years, measles outbreaks hit 103 countries – home to roughly three-quarters of the world’s infants. Low vaccine coverage (80% or less) was a major factor. In contrast, 91 countries with strong measles vaccine coverage did not experience outbreaks.

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