Childhood immunization rates have seen a slight improvement globally, but the progress is fragile and uneven, with millions of children still missing out on life-saving vaccines. According to the annual WHO-UNICEF Estimates of National Immunization Coverage (WUENIC), 90% of infants worldwide received at least one dose of the diphtheria, tetanus, and pertussis (DTP) vaccine in 2025, and 85% completed the full three-dose series. While these figures represent a one-percentage-point increase from the previous year, they remain below 2019 levels, highlighting the ongoing challenges in maintaining and expanding immunization coverage. The data also reveals a concerning trend of children starting the vaccination schedule but not completing it, with an estimated 13.5 million "zero-dose" children in 2025, down from 750,000 fewer children the previous year. This trend is particularly pronounced in conflict-affected and fragile settings, where political upheaval, insecurity, and underfunding strain immunization programs. For instance, Syria lost 6 percentage points in DTP1 coverage and 12 points in MCV1 in a single year, while Sudan recorded the largest single-country gain globally, increasing DTP1 coverage by 35 percentage points. In middle- and high-income countries, even where vaccines are accessible, coverage is slipping due to shifting political commitment, structural challenges, and rising hesitancy. South Africa's DTP1 coverage has fallen 20 percentage points since 2019, and Bosnia and Herzegovina saw a 23-point drop in MCV1 coverage in the past year. The progress made over the past 25 years, thanks to sustained investments and public trust, has reduced the annual number of zero-dose children by 40%. However, the foundations enabling this progress are now under significant strain, with cuts to international health financing and weakening investments in data systems threatening to reverse gains. To address these challenges, WHO and UNICEF call on governments and partners to strengthen immunization in conflict and fragile settings, counter false and misleading health information, increase funding for immunization programs, and invest in stronger data and disease surveillance systems. The global Immunization Agenda 2030 (IA2030) goal to ensure vaccines reach everyone, everywhere, at every age, remains out of reach, and the world must act swiftly to bridge the critical gap and protect vulnerable children from preventable diseases.
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