Childhood Immunization: Global Progress and Challenges Amid Conflict (2026)

In a world where conflict and misinformation often threaten to derail progress, the story of global childhood immunization rates offers a glimmer of hope and a testament to the resilience of public health initiatives. Despite the challenges posed by the COVID-19 pandemic and ongoing geopolitical tensions, the latest data from UNICEF and the World Health Organization (WHO) reveals a remarkable resilience in global vaccination efforts.

A Tale of Two Trends

The numbers speak for themselves: in 2025, an impressive 90% of infants worldwide received at least one dose of the DTP vaccine, and 85% completed the full three-dose series. This is a one-percentage-point increase from the previous year, indicating a steady recovery from the pandemic-induced dip. However, the global coverage remains slightly below the 2019 levels, hovering within a narrow range since 2009. This stagnation is a cause for concern, especially when considering the millions of children who remain unprotected.

The Zero-Dose Dilemma

One of the most critical issues highlighted in the report is the persistence of 'zero-dose' children - those who receive no vaccines in their first year. While the number of zero-dose children has decreased by nearly 750,000 from the previous year, this progress is overshadowed by a rising number of children who start the vaccination schedule but fail to complete it. Most of these children reside in countries supported by Gavi, the Vaccine Alliance, indicating a need for improved retention strategies.

Measles: A Highly Contagious Concern

The report also sheds light on the stalled measles coverage, with only 84% of children receiving the first measles dose (MCV1) and a mere 77% receiving the second dose (MCV2). This falls significantly short of the 95% threshold required to prevent outbreaks of this highly contagious virus. Consequently, 57 countries reported large or disruptive measles outbreaks in 2025, emphasizing the urgent need for improved measles vaccination rates.

Regional Disparities and Conflict's Impact

The data reveals stark regional disparities. While the Americas and South-East Asia have fully recovered and improved their performance, with the latter now the highest-performing region, other regions lag behind. Africa, the Eastern Mediterranean, and Europe regions, though showing gains last year, still have coverage below pre-COVID-19 pandemic levels. The Western Pacific, on the other hand, experienced a decline, leaving it the region furthest below its 2019 baseline. These regional variations highlight the complex interplay of political, social, and economic factors influencing vaccination rates.

Fragile Settings and the Challenge of Access

More than half of all zero-dose children live in fragile, conflict-affected, or vulnerable (FCV) settings, despite these areas accounting for only about a third of the world's child population. In these challenging environments, immunization programs are often strained by political upheaval, insecurity, or chronic underfunding. For instance, Syria lost significant ground on DTP1 and MCV1 coverage, while Sudan, despite ongoing conflict, recorded the largest single-country gain globally last year, demonstrating the potential for progress even in difficult circumstances.

Wealth, Hesitancy, and Structural Challenges

In middle- and high-income countries, even where vaccines are fully accessible, coverage is slipping due to shifting political commitment, structural challenges, or rising hesitancy. South Africa's DTP1 coverage has declined significantly since 2019, and Bosnia and Herzegovina, after a brief increase, saw a substantial drop in MCV1 coverage. These trends highlight the importance of sustained political will and community engagement in maintaining high vaccination rates.

The Power of Collaboration and Trust

Over the past 25 years, sustained investments, community commitments, and strengthened programs have reduced the annual number of zero-dose children by 40%. Countries supported by Gavi, for example, have seen a remarkable increase in average coverage across WHO-recommended vaccines. However, the foundations of this progress are under strain due to funding constraints, geopolitical uncertainty, and increasing outbreaks. The decline in national immunization surveys, from 50 in 2024 to just 18 this round, is a worrying indicator of the potential for backsliding.

A Call to Action

To address these challenges and bridge the critical gap, WHO and UNICEF call for a multi-pronged approach. This includes strengthening immunization efforts in conflict and fragile settings, countering false health information, increasing and sustaining funding for immunization programs, and investing in stronger data and disease surveillance systems. Only by addressing these issues can we ensure that every child, regardless of their circumstances, receives the life-saving protection that vaccines provide.

In my opinion, the story of global childhood immunization is a reminder of the power of collective action and the importance of sustained commitment. While the progress is encouraging, there is still much work to be done to ensure that no child is left unprotected. As we navigate the complexities of a rapidly changing world, the health and well-being of our children should remain a top priority.