In 2025, an estimated 13.5 million “zero dose” children will not receive a single vaccine in their first year, including 679,000 Indian children, according to the World Health Organization and UNICEF annual estimates of national immunization coverage (WUENIC) released on Wednesday. Nigeria topped the list with 2.2 million unvaccinated children.
However, 90% of infants globally – or approximately 116 million – received at least one dose of the diphtheria, tetanus, and pertussis (DTP) vaccine, and 85% – or 110 million – completed the full three-dose series, according to the report.
While both indicators rose by one percentage point from the previous year, global coverage remains one point below 2019 levels – and has been hovering within the same narrow range since 2009.
While the zero-dose numbers for children represent nearly 750,000 fewer children than the previous year, the report said the progress is offset by a rise in the number of children who start the schedule but do not complete it. She added that most of these children live in countries where national immunization programs receive support from the Gavi vaccine alliance.
Globally, it is estimated that 7.3 million infants have received the first dose of MMR but have dropped out before receiving the first dose of measles. This dropout rate contributed to discontinuation of measles coverage, with 84% of children receiving the first measles dose (MCV1) and 77% receiving the second dose (MCV2). Both numbers are well below the 95% threshold required to prevent the spread of this highly contagious virus. 57 countries also reported a major or devastating measles outbreak in 2025.
“Governments and health workers have helped global vaccination rates recover after falling dramatically during the COVID-19 pandemic,” said Katherine Russell, UNICEF Executive Director.
“But millions of vulnerable children remain unprotected due to conflict, displacement and poverty. We must reach every child, and we must rebuild trust where it is weakening. No child should suffer from a disease that can be prevented with a simple vaccine.”
Data from 195 countries show that 100 have maintained coverage of at least 90% with three doses of DDT since 2019, with little progress made in expanding this group. Of the countries with coverage below 90% in 2019, 30 have improved their rates over the past six years, but 65 are stagnating or falling behind, including 13 fragile, conflict-affected or at-risk states.
The report highlights a worrying trend that in middle- and high-income countries, even when vaccines are fully available, coverage is declining amid shifting political commitment, structural challenges, or rising hesitancy.
“Every child, whether born into wealth or poverty, peace or conflict, deserves the life-giving protection that vaccines provide,” said Tedros Adhanom Ghebreyesus, Director-General of the World Health Organization. “Immunization is one of the most cost-effective, most equitable and most reliable interventions to protect children’s health and well-being.” “Our greatest safety begins with ensuring that everyone, wherever they are, is protected from the deadly diseases that vaccines can prevent.”
The report said that WHO and UNICEF are working with the Global Alliance for Vaccines and Immunization (GAVI) and other partners to achieve the goal of the Global Immunization Agenda 2030 (IA2030) to ensure that vaccines reach everyone, everywhere, and at all ages.
