World Lagging in Childhood Vaccine Goals: WHO, UNICEF

Doctors administer diphtheria and tetanus vaccinations provided by the World Health Organization (WHO) to children in Haiti displaced by the earthquake in 2010.

The latest data shows the world is off track to meet the targets set by the Immunization Agenda 2030 (IA2030), which aims for 90% global immunisation coverage for essential childhood vaccines and a 50% reduction in the number of unvaccinated children by 2030.

The World Health Organization (WHO) and the United Nations Children’s Fund (UNICEF) released the 2024 Estimates of National Immunization Coverage (WUENIC) on July 15, highlighting both progress and challenges in global childhood immunisation.

WUENIC, the world’s largest dataset on childhood immunisation, reports on 16 antigens across 195 countries.

In 2024, 20 million children missed at least one dose of the diphtheria, tetanus and pertussis (DTP) vaccine, a key global marker for childhood immunisation coverage. Of those, 14.3 million received no vaccines at all — 4 million more than the 2024 target and 1.4 million more than in 2019, the IA2030 baseline year.

“We’ve hit this very stubborn glass ceiling, and breaking through it to protect more children against vaccine-preventable diseases is becoming more difficult,” said Dr. Kate O’Brien, Director of Immunisation, Vaccines and Biologicals at WHO, during a July 14 press briefing.

Conflicts are largely to blame for this challenge. Children living in one of the 26 countries affected by fragility, conflict or humanitarian emergencies are three times more likely to remain unvaccinated than those in stable countries. Half of all unvaccinated children live in these 26 countries.

“These aren’t just numbers. They’re real children in places like Sudan and Yemen, where instability makes vaccine delivery difficult,” said Thanbani Maphosa, Managing Director of Country Programmes for Gavi, the Vaccine Alliance. “In these settings, reaching a child can mean navigating danger, displacement and a fractured health system.”

However, the number of “zero-dose” children (those receiving no vaccines at all) decreased slightly from 14.4 million in 2023 to 14.3 million in 2024. Additionally, 85% of infants globally received three DTP doses in 2024, marking a one-million increase over 2023.

“While that growth may sound modest, for each of those children it means another life protected,” O’Brien said.

Through their Zero-Dose Immunization Program (ZIP), UNICEF and its partners have vaccinated over 1 million children in conflict-affected regions of the Sahel and the Horn of Africa since 2023. In 2024, Gavi supported the protection of more children against more diseases than ever before.

“That’s not just a statistic. It’s a testament to the resilience and determination of countries,” Maphosa added.

Furthermore, two-thirds of countries have maintained at least 90% coverage of four key vaccines over the past five years.

The WUENIC report also noted improving measles immunisation. First-dose coverage rose to 84%, with 1.7 million children vaccinated in 2024, while second-dose coverage increased from 74% in 2023 to 76% in 2024. Nevertheless, 20 million children missed their first measles dose and 12 million did not receive their second, leaving 30 million vulnerable to infection. Globally, 360,000 measles cases were confirmed in 2024, the highest since 2019, and 60 countries reported large, disruptive outbreaks — nearly double the 2022 figure.

Experts warned that rising measles cases are due to the accumulation of unvaccinated people since the start of the COVID-19 pandemic. Dr. Ephrem T. Lemango, Associate Director for Health and Global Chief of Immunisation at UNICEF, cautioned that current progress is insufficient to prevent future outbreaks.

Even where national coverage rates appear high, Lemango warned, regional disparities put many at disproportionate risk. Preventing measles outbreaks requires 95% coverage with two vaccine doses in every community.

Immunisation efforts face challenges, including health facility shortages, workforce gaps, vaccine stockouts and difficulties reaching remote or conflict-affected communities. In high-income countries, vaccine hesitancy—fuelled by misinformation and distrust in institutions—remains a major obstacle. Funding cuts have disrupted immunisation programmes in nearly 50 countries.

“Misinformation and vaccine hesitancy reflect a broader mistrust in health systems, health workers, and the vaccine manufacturing ecosystem,” Lemango explained.

Social media and the COVID-19 pandemic have significantly contributed to vaccine misinformation.

Both Lemango and O’Brien emphasised the importance of training health workers to address parental concerns and highlighted the critical role of community leaders in influencing public trust. According to O’Brien, local health workers remain the most trusted voices regarding vaccination.

“Political leaders, community leaders, religious leaders and family leaders have a powerful influence on families’ decisions around child health,” she said. “Their voices can either reinforce or erode trust.”

However, O’Brien noted that lack of access, rather than misinformation, remains the primary barrier to vaccination. Lemango pointed out that 95% of parents want their children vaccinated.

One notable success is HPV vaccination. In 2024, 43 million girls were vaccinated against HPV, putting the world on track to reach 86 million adolescents by 2025. To date, 60 million girls have been protected against cervical cancer — more than in any previous decade.

Despite record levels of domestic immunisation financing in many countries, a funding gap remains. Of the USD 11.9 billion needed to meet IA2030 targets, only USD 9 billion has been raised.

Maphosa stressed that millions of children remain unreached and that there is no single solution. Lemango urged governments, partners and communities to close funding gaps, serve fragile populations and combat misinformation.

Maphosa highlighted the urgency, given global increases in conflict, fragility and population growth.

“Vaccines have never been more important or more urgent than they are now,” he said. “Together, countries and organisations must work to close the immunisation gap so that every child is protected.”

“That’s the promise of immunisation,” he concluded. “One of the best tools the world has to ensure health, security and prosperity. And with continued commitment and investment, it’s a promise we can keep.”