• Global childhood immunisation coverage stalled in 2023, leaving around 2.7 million lacking the protection they need compared to the pre-COVID-19 levels of 2019, according to data published by the World Health Organisation (WHO) and UNICEF.

• The latest WHO and UNICEF estimates of national immunisation coverage (WUENIC) – which provide the world’s largest and most comprehensive dataset on immunization trends for vaccinations against 14 diseases – underscore the need for ongoing catch-up, recovery and system-strengthening efforts.

• These trends, which show that global immunisation coverage has remained largely unchanged since 2022 and has still not returned to 2019 levels, reflect ongoing challenges with disruptions in healthcare services, logistical challenges, vaccine hesitancy and inequities in access to services.

• Closing the immunisation gap requires a global effort, with governments, partners, and local leaders investing in primary healthcare and community workers to ensure every child gets vaccinated, and that overall healthcare is strengthened.

• According to the findings, the number of children who received three doses of the vaccine against diphtheria, tetanus, and pertussis (DTP) in 2023 – a key marker for global immunisation coverage – stalled at 84 per cent (108 million). 

• The number of children who did not receive a single dose of the vaccine increased from 13.9 million in 2022 to 14.5 million in 2023.

• Additionally, 6.5 million children did not complete their third dose of the DTP vaccine, which is necessary to achieve disease protection in infancy and early childhood.

• More than half of unvaccinated children live in the 31 countries with fragile, conflict-affected and vulnerable settings, where children are especially vulnerable to preventable diseases because of disruptions and lack of access to security, nutrition, and health services.

Low vaccine coverage already driving measles outbreaks

• The data further show that vaccination rates against the deadly measles disease stalled, leaving nearly 35 million children with no or only partial protection.

• In 2023, only 83 per cent of children worldwide received their first dose of the measles vaccine through routine health services, while the number of children receiving their second dose modestly increased from the previous year, reaching 74 per cent of children. 

• These figures fall short of the 95 per cent coverage needed to prevent outbreaks, avert unnecessary disease and deaths, and achieve measles elimination goals.

• Over the last five years, measles outbreaks hit 103 countries — home to roughly three-quarters of the world’s infants. Low vaccine coverage (80 per cent or less) was a major factor. In contrast, 91 countries with strong measles vaccine coverage did not experience outbreaks.

Global HPV vaccine coverage among girls increased substantially

• The new data also highlight some brighter spots in immunisation coverage. The steady introduction of new and under-utilised vaccines, including for human papillomavirus (HPV), meningitis, pneumococcal, polio and rotavirus disease, continue to expand the breadth of protection, particularly in the 57 countries supported by Gavi, the Vaccine Alliance.

• For example, the share of adolescent girls globally who received at least one dose of the HPV vaccine, which provides protection against cervical cancer, increased from 20 per cent in 2022 to 27 per cent in 2023. 

• This was largely driven by strong introductions in Gavi-supported countries, such as Bangladesh, Indonesia, and Nigeria. The use of the single-dose HPV vaccine schedule also helped boost vaccine coverage.

• However, HPV vaccine coverage is well below the 90 per cent target to eliminate cervical cancer as a public health problem, reaching only 56 per cent of adolescent girls in high-income countries and 23 per cent in low and middle-income countries.