Ninety percent of the world’s infants received at least one dose of a basic vaccine last year, and the number of children who never got a single shot fell by nearly 750,000 — but a growing dropout rate is fueling measles outbreaks across dozens of countries, according to new data from WHO and UNICEF.
The annual Estimates of National Immunization Coverage, released Wednesday, show that 116 million infants received at least one dose of the diphtheria-tetanus-pertussis (DTP) vaccine in 2025, and 110 million completed the full three-dose series. Both figures rose by one percentage point from the previous year, though global coverage remains one point below its 2019 pre-pandemic peak — stuck in the same narrow band it has hovered in since 2009.
The headline gain — 13.5 million “zero-dose” children in 2025, down from over 14 million the year before — is undercut by a rising number of children who start their vaccination schedule but do not finish it. An estimated 7.3 million infants received their first DTP dose but dropped out before getting a measles shot, contributing to stalled measles coverage at 84% for the first dose and 77% for the second. Both fall far short of the 95% threshold needed to prevent outbreaks of the highly contagious virus. Fifty-seven countries reported large or disruptive measles outbreaks last year.
“Millions of vulnerable children are still being left unprotected due to conflict, displacement, and poverty,” said UNICEF Executive Director Catherine Russell. “We must reach every child, and we must rebuild trust where it is fraying.”
The data, drawn from 195 countries, reveals sharp regional divides. The Americas and South-East Asia have fully recovered and even improved on their 2019 baselines, with South-East Asia now the highest-performing region. Africa, the Eastern Mediterranean, and Europe saw gains last year but remain below pre-pandemic levels. The Western Pacific experienced a decline, leaving it the furthest below its 2019 starting point.
Country-level results swing wildly. Sudan recorded the largest single-country gain globally, lifting DTP1 coverage by 35 percentage points and the first measles dose by 22 — demonstrating what is possible when access to services improves even amid ongoing conflict. Syria, by contrast, lost 6 points on DTP1 and 12 on measles coverage in a single year. In middle- and high-income settings, slippage is driven less by conflict than by shifting political priorities, structural challenges, or rising vaccine hesitancy: South Africa’s DTP1 coverage has fallen 20 points since 2019, and Bosnia and Herzegovina saw a 23-point drop in measles coverage in the past year alone.
More than half of all zero-dose children live in fragile or conflict-affected settings, even though these countries account for roughly a third of the world’s child population. “Our greatest security begins with ensuring that everyone, wherever they may live, is protected from deadly diseases,” said WHO Director-General Tedros Adhanom Ghebreyesus.
The agencies also flagged a quieter crisis in data. Only 18 national immunization surveys were completed this round, down from 50 in 2024 and an average of 33 per year between 2015 and 2019. Without reliable data, health systems cannot identify or reach the children who are missing out, the agencies warned.
Over the past 25 years, sustained investment has cut the annual number of zero-dose children by 40%, and in countries supported by Gavi, the Vaccine Alliance, children today are protected against more diseases than ever before. But the foundations of that progress are under strain from funding constraints, geopolitical uncertainty, and the full impact of recent cuts to international health financing — which has not yet shown up in these numbers.
WHO and UNICEF called on governments to strengthen immunization in conflict settings, counter health misinformation, sustain funding for programs including Gavi, and invest in data and disease surveillance systems.
Source: WHO-UNICEF Joint News Release
