Global vaccine coverage against diphtheria, tetanus and pertussis rises slightly in 2025 but remains off target due to conflict and hesitancy

According to the National Immunization Coverage Estimates (WUENIC) report for 2025 released today by the World Health Organization (WHO) and the United Nations Children's Fund (UNICEF), 90% of babies worldwide have received at least one dose of diphtheria, tetanus and pertussis (DTP) vaccine, while 85% have completed the three-dose series. Although these rates increased by only one point compared to the previous year, the global coverage rate remains one point below 2019 levels. The report estimates that in 2025, approximately 13.5 million 'zero-dose' children will receive no vaccine in their first year. Although this number decreased by 750 thousand compared to the previous year, the increase in the number of children who started but did not complete the vaccination program causes progress to be negatively affected.

What happened?

According to the report, it was determined that 116 million babies worldwide will receive at least one dose of DTP vaccine in 2025, and 110 million will complete the three-dose series. However, global coverage rates remain below 2019 levels and have fluctuated within a narrow range since 2009. During the same period, it is estimated that 7.3 million babies received their first dose of DTP but left the program without receiving their first dose of measles. This led to a decline in global coverage for the measles vaccine (MCV1) to 84% and for the second dose (MCV2) to 77%. Both rates remained well below the 95% threshold needed to prevent outbreaks of this highly contagious virus. As a result, major or interrupted measles outbreaks have been reported in 57 countries in 2025.

UNICEF Executive Director Catherine Russell said in a statement: "Governments and health workers have managed to increase vaccination rates, which had fallen significantly during the COVID-19 pandemic. However, millions of vulnerable children remain unprotected due to conflict, displacement and poverty. We must reach every child and work to rebuild trust. No child should suffer from a disease that can be prevented with a simple vaccine."

Background

According to annual forecasts of WHO and UNICEF, the DTP three-dose coverage rate has been maintained at at least 90% since 2019 in 100 out of 195 countries by 2025. However, progress was made in only 30 of the countries below 90% in 2019, while 65 countries experienced stagnation or decline. Among these countries, 13 were classified as countries at risk of conflict, fragility or fragility (FCV). At the regional level, the Americas and Southeast Asia regions have fully recovered from 2019 levels and are making progress, while the Africa, Eastern Mediterranean and European regions have made gains over last year but remain below pre-COVID-19 levels. In contrast, the Western Pacific region experienced the largest decline, remaining well below 2019 levels.

The report points out that in environments of conflict and fragility, vaccine programs suffer from political instability, insecurity or chronic underfunding. For example, in Syria, DTP1 coverage dropped by 6% and MCV1 coverage dropped by 12% in one year. In contrast, Sudan recorded the largest single country gain globally last year, increasing DTP1 coverage by 35% and MCV1 coverage by 22%. This was made possible by improved access to services.

Why is it important?

While the slight increase in global vaccine coverage rates points to a partial recovery of health systems in the post-pandemic era, it shows that millions of children still remain unprotected. Inadequate vaccination rates against infectious diseases such as measles increase the risk of epidemics and can lead to fatal consequences, especially for children living in conflict zones. While WHO and UNICEF officials emphasize that every child should have access to vaccination, they state that trust must be rebuilt and vaccine hesitancy must be combated. The report warns that the full effects of cuts in international health financing have not yet been seen, but data systems are also at risk of decline.

What do experts and parties say?

“Governments and health workers have managed to restore vaccination rates, which had fallen significantly during the COVID-19 pandemic, but millions of vulnerable children remain unprotected due to conflict, displacement and poverty,” said UNICEF Executive Director Catherine Russell.

WHO Director-General Dr. Tedros Adhanom Ghebreyesus said, "Every child, whether born into wealth or poverty, peace or conflict, deserves the life-saving protection provided by vaccines. Vaccines are one of the most cost-effective, fairest and most reliable interventions to protect child health and well-being."

Gavi Vaccine Alliance CEO Dr. Sania Nishtar said, "Historic vaccine coverage levels in low-income countries show what can be achieved when all stakeholders work towards a common goal. As Gavi enters its new five-year term, the big challenge we face will be to do more to reach children who do not have access to vaccines, while dealing with funding constraints, geopolitical uncertainties and increasing epidemics."

What to watch next?

To achieve the global Immunization Agenda 2030 (IA2030) target, WHO and UNICEF call on governments and relevant stakeholders to strengthen vaccination in settings of conflict and fragility, improve data systems and combat vaccine hesitancy. The report warns that the full effects of cuts in international health financing have not yet been seen, but data systems are also at risk of decline. WHO and UNICEF state that the weakening of data systems will make it difficult to find and reach children who are deprived of vaccines and may lead to preventable epidemics and deaths. Organizations are calling for urgent action to close this critical gap and achieve goals.