The global childhood vaccination rate in 2024 held steady with 85% of infants and children receiving three doses of the vaccine for diphtheria, pertussis and tetanus (DPT), used as a global benchmark for immunization rates overall.
“In 2024 85% of infants around the world, about 109 million infants received three doses of the core vaccine, the DTP-containing vaccine that is the global marker for routine childhood immunization coverage,” said WHO’s Katherine O’Brien, head of Immunizations, Vaccines and Biologicals. She spoke to reporters just ahead of Tuesday’s publication of 2024 data on global vaccination rates by WHO and UNICEF, the UN children’s organization.
The data, considered the most comprehensive in the world, tracks rates of childhood vaccination against 16 major diseases across 195 countries.
“There’s both progress and pressing challenges in the data from 2024,” O’Brien said, noting that in absolute numbers 1 million more children received basic vaccinations in 2024, as compared to 2023.
“At the same time, the latest estimates highlights a really concerning trajectory,” she added. “The world is currently off track for the SDG [2030 Sustainable Development Goal target] to halve the number of ‘zero dose’ children and achieve at least 90% global immunization coverage.
“In 2024 nearly 20 million children missed at least one dose of DTP, and of these 20 million children, 14.3 million never received even a single dose of any vaccine.”
Hit a stubborn glass ceiling
“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,” she stressed.
Wars are a key reason for persistent under-vaccination in key parts of the world.
“Conflicts throughout the world are eroding immunization progress. Children living in one of 26 countries affected by fragility, conflict or humanitarian emergencies are three times more likely to be unvaccinated compared to children who live in stable countries,” O’Brien said.
“In fact, half of all children unvaccinated in the world live in these fragile, vulnerable and conflict countries, while two-thirds of [other] countries in the world have maintained at least 90% coverage of core vaccines in the past five years, which is great news.
However, even in politically stable countries, there are some “emerging signs of slippage, and in other countries, stalling of vaccine coverage,” O’Brien noted, saying that “even the smallest drops in immunization coverage as measured at the country level, can have devastating consequences. It opens the door to deadly disease outbreaks and puts even more pressure on health systems that are already stretched.”
Along with conflicts, vaccine disinformation is another factor at play, playing on parents’ fears about their children’s health and well-being. And that can fuel vaccine hesitancy, raising dangerous pockets of under-vaccination to the level of a national threat.
“We don’t have a way to quantify what fraction of people who aren’t vaccinated at a global level are making those choices because of incorrect information that they’re receiving,” O’Brien said. “But what we do know is that this information is scaling very fast. around social media channels, it’s influencing people the use of social media is highly influential on what people believe, and yet the most influential factor is the advice from an individual’s local medical practitioner
Measles as a case in point
The rising number of measles outbreaks, and people infected in the United States and worldwide is one case in point, said UNICEF’s Ephrem Lemango in the briefing.
It typifies the paradox: on the one hand global immunization rates can improve, while persistent pockets of under-vaccination still generate consequences.
“The first dose of measles containing vaccine coverage this year rose to about 84% in 2024 which is a little higher than what we had in 2023 and due to this improvement, an estimated additional 1.7 million children had measles vaccination,” he said, attributing the progress to improved measles vaccine rates in Africa, the Americas and South East Asia.
Coverage for a second dose of measles vaccine also increased to 76%, above 74% in 2023 – reflecting the rebound from the setbacks of the COVID-19 pandemic.
“But these gains are not keeping up with the level needed to stop outbreaks, and that is why you keep on hearing there are an increasing number of outbreaks in different countries,” said Lemango, noting that you need a 95% measles vaccine coverage to protect communities entirely against the spread of the highly contagious virus.
In 2024, about 20 million children missed their first measles dose while another 12 million children didn’t get their second dose – leaving about 30 million children globally still vulnerable to measles infections.
“Over half of these children are in the African region and in countries affected by conflict and fragility, such as Sudan, Yemen and Afghanistan,” he pointed out.
But there are also uncovered pockets in countries like the United States, whose national vaccine rates appear to be high otherwise.
World sees highest rate of measles cases since 2019
“This immunity gap resulted in about 360,000 confirmed measles cases be reported in 2024 which is the highest we have seen since 2019 as a global community,” Lemango said.
“Immunization efforts face distinct challenges across different contexts, and this could range from access to acceptance-related challenges,” Lemango said.
“Challenges like fewer health facilities, workforce shortage, vaccine stock outs and difficulty to reach remote communities are leaving millions of children unprotected. These barriers are especially acute in conflict effects or displacement settings.
“But in high-income countries, decreased acceptance or even slight vaccine hesitancy driven by misinformation or distrust in institutions tend to cause the resurgence of vaccine preventable diseases like measles. And the result is that children are left vulnerable to vaccine-preventable diseases across countries.”
Added O’Brien, some 60 countries have had large or disruptive measles outbreaks over the past 12 months.
“Contrast that with just 24 months ago, when the number around the world was only 32 countries,” she said, noting that some countries are still experiencing a backlash in vaccine hesitancy that is a legacy of the COVID pandemic.
“What we see now are the impacts from the pandemic and from the inability at this point for countries around the world to really get in and fill those immunity gaps,” O’Brien said. “And part of the threat is mis- and disinformation – anything that’s done that discourages parents from believing and knowing, in fact, that vaccines are safe and effective.”
Funding cuts further threaten progress
Global progress is also under threat from the massive cuts by the United States in assistance for vaccine rollout and vaccine surveillance. Those are related to the Trump Administration’s January withdrawal from the World Health Organization, followed by the dismantling of USAID and deep budget cuts in the National Institutes of Health and the US Centers for Disease Control, among other institutions.
“Progress is under threat by growing funding cuts, particularly for immunization services and disease surveillance,” observed Lemango. “Our ability to respond to [measles] outbreaks in nearly 50 countries has been disrupted.
On a brighter note, the 25 June replenishment drive for Gavi, the Vaccine Alliance, raised more than $9 billion out of Gavi’s $11.2 billion five-year goal. And that was despite the US withdrawal of support for the initiative founded 25 years ago by the Bill and Melinda Gates Foundation.
“In 2024 Gavi supported lower income countries to vaccinate more children than ever before – against more diseases than at any point in history,” declared Thabani Maphosa, Gavi’s managing director of country programmes. That is not just a statistic. It is a testament to the resilience and determination of countries. They are also committing record amounts of domestic financing to immunization.
“Countries like Mali, DR Congo, Rwanda and Ethiopia made major strikes, helping Africa recover immunization coverage to pre pandemic levels, even as birth rates were rising, coverage across all vaccines – with significant gains in protecting against polio, measles, pneumonia, rotavirus, yellow fever and cervical cancer,” he said.
The HPV vaccine that protects against most forms of cervical cancer, is a particular success story, he noted:
“Nearly 60 million girls are now protected against cervical cancer, and more were protected in 2024 than in the previous decade. This progress, following on from a strategic investment in 2022, puts Gavi on track to reach 86 million girls by the end of 2025.” See related story:
Malawi Acts to Overcome COVID-era Setbacks in HPV Vaccination
Image Credits: UNICEF 2024 , WHO/UNICEF 2025.
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