United Nations — The latest data highlights that the world is off track to meet the targets set by the Immunization Agenda 2030 (IA2030) to achieve 90 percent global immunization coverage for essential childhood vaccines and halve 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, revealing both progress and challenges in global childhood immunization.
WUENIC, the world’s largest dataset on childhood immunization, reports on 16 antigens across 195 countries.
In 2024, 20 million children did not receive at least one dose of the diphtheria, tetanus and pertussis (DTP) vaccine, a global marker for childhood immunization coverage. Of those children, 14.3 million received no vaccines at all. This is 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 that glass to protect more children against vaccine-preventable diseases is becoming more difficult,” Dr. Kate O’Brien, Director of the Department of Immunization, Vaccines and Biologicals at WHO, said at a July 14 press briefing.
Conflicts are much to blame for the difficulty in immunization. Children living in one of the 26 countries affected by fragility, conflict or humanitarian emergencies are three times more likely to be unvaccinated than those who live in stable countries. Half of unvaccinated children live in these 26 countries.
“These aren’t just numbers. They are real children in places like Sudan and Yemen, where instability makes vaccine delivery difficult,” Thanbani Maphosa, Managing Director of Country Programmes for Gavi, the Vaccine Alliance, said. “In these settings, reaching a charge can mean navigating danger, displacement and a fractured health system.”
However, the 14.3 zero-dose children is a reduction from the 2023 number of 14.4 zero-dose children, and 85 percent of infants in the world received three doses of the DTP in 2024, an increase of 1 million more from 2023.
“While that growth may sound modest, in each of these children, this means another child protected at the same time,” O’Brien said.
Through their Zero-Dose Immunization Program (ZIP), UNICEF and partners have vaccinated over 1 million children in conflict-affected regions of the Sahel and the Horn of Africa since 2023. In 2024, Gavi, the Vaccine Alliance, supported more children against more diseases than ever before.
“That is not just a statistic. It is a testament to the resilience and determination of countries,” Maphosa said.
Furthermore, two-thirds of countries have maintained at least 90 percent coverage of four key vaccines over the past five years.
WUENIC reports there is improving immunization against measles. First-dose coverage rose to 84 percent, with 1.7 million children vaccinated in 2024, while second-dose coverage increased from 74 percent in 2023 to 76 percent in 2024.
Still, 20 million children missed their first dose, and 12 million did not complete their second, leaving 30 million at risk for measles. 360,000 measles cases were confirmed globally in 2024, the highest number since 2019. The number of countries with large and disruptive measles outbreaks rose to 60, almost double the 2022 number.
The rise in cases is due to an accumulation of people who are unvaccinated since the COVID-19 pandemic began.
Dr. Ephrem T. Lemango, Associate Director for Health and Global Chief of Immunization at UNICEF, warned that the progress made in 2024 is not enough to prevent measles outbreaks.
Lemango warned that even where national coverage rates appear high, disparities among districts put many disproportionately at risk. Measles outbreaks can only be prevented with 95 percent coverage with two measles vaccine doses in every community in every county.
Immunization efforts are challenged by fewer health facilities, workforce shortages, vaccine stockouts, and difficulties reaching remote communities, especially in areas affected by conflict or displacement. In high-income countries, immunization is challenged by decreased acceptance and vaccine hesitancy due to misinformation and distrust in institutions. Funding cuts are further putting children at risk for vaccine-preventable diseases. Nearly 50 countries have been disrupted by funding cuts.
“Misinformation and any forms of vaccine hesitancy are a reflection of a broader lack of trust or mistrust in the systems that deliver the vaccines, in the health workers that provide the vaccines, in the manufacturing facilities or ecosystem that manufactures the vaccines,” Lemango said.
Social media and the COVID-19 pandemic are largely to blame for disinformation and misinformation surrounding vaccines.
Lemango and O’Brien emphasized the importance of training health workers to address the questions and concerns of parents in regard to vaccinating their children and the critical role community leaders play in influencing public trust. O’Brien noted that a family’s local medical practitioner is the most influential voice in their decision to vaccinate their children.
“Political leaders, community leaders, religious leaders, and family leaders have a powerful influence on the choices that families make around the health of their children, and the voices of leaders can either reinforce trust or erode trust,” O’Brien said.
However, O’Brien emphasized that lack of access remains the primary barrier to immunization, rather than misinformation. Lemango noted that 95 percent of parents want their children to be vaccinated.
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An area of notable progress is HPV vaccination. 43 million girls were vaccinated against HPV in 2024, setting the world on track to reach 86 million adolescents by the end of 2025. 60 million girls are now protected against cervical cancer, more than in any previous decade.
He noted that many countries are committing record levels of domestic financing to immunization, but a funding gap persists. Of the USD 11.9 billion needed to achieve their goals, only USD 9 billion has been raised.
Maphosa noted that millions of children are still not being reached and there is no “one-size-fits-all” solution. Lemango called on governments, partners and communities to close funding gaps, serve fragile or conflict-affected communities and address misinformation.
Maphosa emphasized the urgency of the situation, given a global rise in conflict, fragility and population. “Vaccines have never been more important and urgent than they are now,” he said.
He added that countries and organizations must work together to close the immunization gap so that every child is protected.
“That’s the promise of immunization,” he said. “One of the best tools the world has to ensure health, security and prosperity. And with continued commitment and continued investment, it’s a promise we can keep.”
