Global Immunization Progress in 2024 Shows Gains, But Millions Still Unprotected

New data released by the World Health Organization (WHO) and UNICEF in 2024 reveals a mix of progress and persistent challenges in the global effort to protect children from vaccine-preventable diseases. While more children are receiving life-saving immunizations, nearly 20 million infants remain under- or unvaccinated—placing them at heightened risk of deadly diseases such as diphtheria, tetanus, pertussis, measles, and others.

Modest Gains in DTP Coverage Signal Hope Amid Challenges

In 2024, 89% of infants worldwide—approximately 115 million—received at least one dose of a diphtheria, tetanus, and pertussis (DTP)-containing vaccine. About 85% (109 million) of those completed the full three-dose schedule. Compared to 2023, this represents an additional 171,000 children who received their first dose and a remarkable increase of one million children completing the entire course. Although modest, these gains show resilience and progress, especially in the face of disrupted health systems, funding shortages, and rising vaccine hesitancy.

However, nearly 20 million infants missed at least one DTP dose in 2024. Of this group, 14.3 million are “zero-dose” children—those who have never received any vaccination. This figure exceeds the 2024 target necessary to remain on track with the Immunization Agenda 2030 (IA2030), the global strategy to leave no one behind in immunization.

Dr. Tedros Adhanom Ghebreyesus, WHO Director-General, noted, “It’s encouraging to see a continued increase in the number of children being vaccinated, although we still have a lot of work to do. Drastic cuts in aid, coupled with misinformation about the safety of vaccines, threaten to unwind decades of progress.”

Equity Gap Widens Amid Conflict and Fragility

The immunization divide between nations is increasingly shaped by conflict, humanitarian crises, and systemic fragility. While 131 countries have consistently maintained over 90% DTP first-dose coverage since 2019, there has been little improvement in expanding this group. Only 17 countries previously below that threshold have made gains in the last five years.

More worryingly, 47 countries have stalled or regressed. Of these, 22 nations once surpassing the 90% target in 2019 have now fallen below. Countries affected by fragility and conflict are especially impacted—26 such nations account for a quarter of the world’s infant population but represent half of the global total of unvaccinated children. The number of unvaccinated children in these conflict-affected countries grew from 3.6 million in 2019 to 5.4 million in 2024, highlighting the urgent need for immunization to be a central part of humanitarian response strategies.

Gavi Support Boosts Coverage in Low-Income Countries

In contrast to stagnation elsewhere, the 57 low-income countries supported by Gavi, the Vaccine Alliance, have shown improvement. In the past year, these nations reduced the number of under- and unvaccinated children by approximately 600,000.

Gavi-supported countries are also broadening their immunization portfolios, offering more vaccines than ever before. Dr. Sania Nishtar, CEO of Gavi, emphasized, “In 2024, lower-income countries protected more children than ever before… but fragility and conflict present major hurdles to achieving equity.”

Despite their success, the challenges of conflict, rapid population growth, and weak health systems continue to constrain further progress. Meanwhile, high- and upper-middle-income countries—long considered immunization strongholds—are showing signs of slippage. Even small declines in immunization coverage in these countries can trigger large-scale disease outbreaks and strain public health systems.

Expanding Vaccine Coverage Against More Diseases

Encouragingly, efforts to broaden protection beyond DTP are taking shape. Notable progress has been recorded in coverage for the human papillomavirus (HPV) vaccine. In 2024, 31% of eligible adolescent girls received at least one dose of the HPV vaccine—up from 17% in 2019. Much of this improvement is driven by national campaigns and the adoption of single-dose schedules in several countries.

Coverage of other major vaccines also improved slightly. Global measles immunization reached 84% for the first dose and 76% for the second dose. While this marks an increase of approximately two million children compared to the previous year, the numbers still fall short of the 95% coverage needed to prevent outbreaks.

And outbreaks are on the rise. In 2024, 60 countries experienced large or disruptive measles outbreaks, nearly doubling the number from just two years prior. More than 30 million children remain under-protected against the disease, further threatening progress in global immunization.

Barriers to Immunization: From Misinformation to Budget Cuts

Numerous systemic and situational factors continue to hinder full vaccine coverage:

• Shrinking health budgets: Financial constraints at the national and international levels threaten the sustainability of routine immunization programs.

• Fragile and overburdened health systems: Especially in conflict-affected areas, immunization efforts are limited or disrupted entirely.

• Misinformation and vaccine hesitancy: The rapid spread of false information has eroded public trust in vaccines in several regions.

• Inequitable access: Even where vaccines are available, logistical, geographic, and social barriers often prevent the most vulnerable from receiving them.

UNICEF Executive Director Catherine Russell urged renewed commitment: “We must act now with determination to overcome barriers like shrinking health budgets, fragile health systems along with misinformation and access constraints because of conflicts. No child should die from a disease we know how to prevent.”

Strategic Actions to Secure Future Gains

WHO and UNICEF are urging global leaders and stakeholders to respond decisively:

1. Close the Gavi funding gap for the 2026–2030 strategic cycle to ensure continued support for low-income countries.

2. Strengthen immunization in fragile settings, making vaccines central to humanitarian aid.

3. Embed immunization in primary healthcare systems, increasing domestic investment and community-driven strategies.

4. Combat vaccine misinformation using evidence-based communication.

5. Enhance data systems and disease surveillance to enable targeted, impactful immunization efforts.

The Road Ahead: Protecting Every Child

While global immunization coverage has improved modestly, the rising number of zero-dose and under-vaccinated children—especially in the world’s most vulnerable regions—remains a serious concern. The promise of immunization as a fundamental right for every child is at risk of being undermined by conflict, complacency, and misinformation.

The momentum built in recent years must be preserved and expanded through strategic partnerships, sustained financing, and grassroots engagement. Only with unified global commitment can we fulfill the Immunization Agenda 2030 vision: a world where no child dies from a vaccine-preventable disease.