No fewer than 13.5 million infants missed all routine vaccines in 2025, as the World Health Organisation (WHO) and UNICEF warned that conflict, poverty and vaccine hesitancy are slowing global immunisation progress, leaving millions of children vulnerable to preventable diseases.

The warning came Tuesday as the two agencies released the latest WHO-UNICEF Estimates of National Immunisation Coverage (WUENIC), showing that despite gains since the COVID-19 pandemic, vaccination coverage remains below pre-pandemic levels.

The report showed that 90 per cent of infants worldwide, nearly 116 million children, received at least one dose of the diphtheria, tetanus and pertussis (DTP) vaccine in 2025, while 85 per cent, or about 110 million children, completed the recommended three-dose schedule. Although both figures rose by one percentage point from 2024, global coverage remains below the level recorded in 2019.

WHO and UNICEF said the number of children who received no routine vaccines fell by nearly 750,000 compared with the previous year.

They warned that progress is being undermined by millions of children who begin vaccination but fail to complete the schedule.

The report found that 7.3 million infants received the first DTP dose but did not receive their first measles vaccine, contributing to stagnant global measles coverage. Only 84 per cent of children received the first dose of the measles vaccine, while 77 per cent received the second dose, far below the 95 per cent coverage required to prevent outbreaks.

The low coverage contributed to 57 countries reporting large or disruptive measles outbreaks in 2025, underscoring the growing threat posed by immunity gaps.

UNICEF Executive Director, Catherine Russell, said while governments and health workers had restored vaccination services after the disruption caused by the COVID-19 pandemic, millions of children remain beyond the reach of lifesaving vaccines.

“Governments and health workers have helped global vaccination rates bounce back after dropping significantly during the COVID-19 pandemic. But millions of vulnerable children are still being left unprotected due to conflict, displacement, and poverty.

“We must reach every child, and we must rebuild trust where it is fraying. No child should suffer from a disease that a simple vaccine can prevent.”

The report showed that 100 countries have maintained at least 90 per cent coverage with three doses of the DTP vaccine since 2019, but progress has slowed elsewhere. Of the countries that were below the target before the pandemic, only 30 improved their vaccination rates, while 65 countries remain stagnant or have recorded declines, including 13 countries affected by conflict or humanitarian crises.

Regional performance also varied. The Americas and South-East Asia have recovered and exceeded their pre-pandemic vaccination levels, while Africa, the Eastern Mediterranean and Europe recorded improvements but remain below their 2019 coverage. The Western Pacific region experienced further declines, making it the region furthest behind its pre-pandemic performance.

WHO and UNICEF said more than half of all zero-dose children now live in fragile and conflict-affected countries, where insecurity, political instability and weak health systems continue to disrupt routine immunisation. The report cited Syria, where DTP coverage fell by six percentage points and measles vaccination dropped by 12 percentage points within one year. In contrast, Sudan recorded one of the world’s largest improvements after expanding access to vaccination services, increasing DTP coverage by 35 percentage points and measles vaccination by 22 percentage points despite the ongoing conflict.

The agencies also raised concerns about falling vaccination rates in some middle- and high-income countries, attributing the trend to vaccine hesitancy, weakening political commitment and structural health system challenges.

WHO Director-General, Dr Tedros Adhanom Ghebreyesus, said vaccines remain one of the most effective public health interventions and urged governments not to allow preventable diseases to regain ground.

“Every child, whether born into wealth or poverty, peace or conflict, deserves the lifesaving protection that vaccines provide. Immunization is one of the most cost-effective, most equitable and most reliable interventions for protecting children’s health and well-being.

“Our greatest security begins with ensuring that everyone, wherever they may live, is protected from deadly diseases that vaccines have the power to prevent.”

The agencies warned that recent cuts in international health financing are beginning to weaken the systems used to monitor vaccination coverage and identify children who miss routine immunization. They noted that only 18 national immunization surveys were submitted in the latest reporting cycle, down from 50 in 2024.

Chief Executive Officer of Gavi, the Vaccine Alliance, Dr Sania Nishtar, said maintaining progress would require sustained investment despite growing financial and geopolitical pressures.

“The historic levels of immunization that we are seeing across lower-income countries show what can be achieved when all stakeholders work together towards a shared objective.

“Our challenge now is to maintain this momentum despite funding constraints, geopolitical uncertainty and increasing disease outbreaks, while reaching children who still have no access to immunisation.”

WHO and UNICEF urged governments and development partners to strengthen immunisation services in conflict-affected communities, tackle vaccine misinformation, increase domestic and international funding, and invest in stronger disease surveillance and health information systems to prevent future outbreaks of vaccine-preventable diseases. (Vanguard)

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