Why Haven’t Millions of Children Received Vaccinations?

Over the past half-century, vaccines for diseases including measles, polio, and tuberculosis have saved over 150 million lives, most of them young children under five.

The Lancet Journal recently published a global study that revealed some unexpected and alarming results.

Routine vaccination rates among children are dropping, with millions still missing out.

Ahead of new cuts that could deepen the crisis, let’s take a closer look at how severe the problem is and which children are suffering as a result.

Completely unvaccinated children

About 14.5 million kids around the world haven’t had a single vaccine. What’s more worrying is that this number jumped by nearly a million in just a year, pointing to a serious decline in child immunisations.

Children who have some vaccinations but not all

On top of that staggering number, another 6.5 million children have only been partially vaccinated—receiving just one or two doses from the full vaccination schedule. That’s 2.7 million more under-vaccinated children than there were before the COVID-19 pandemic.

The effect of COVID

The COVID-19 pandemic significantly disrupted immunisation efforts, with many people not being able to access healthcare facilities and growing hesitant about vaccines. Although rates have begun to rise, they still remain quite below pre-pandemic levels.

Anxiety about vaccines

Between 2019 and 2021, an estimated 67 million children missed at least one routine vaccination. The report also highlights a decline in public trust, with vaccine confidence falling in 52 of the 55 countries that were surveyed during the pandemic.

Coverage of DTP

The DTP vaccine—designed to protect against diphtheria, tetanus, and pertussis (or whooping cough)—has experienced one of the most significant drops in coverage rates.

World decrease

To be fully protected, children need three doses of the DTP vaccine. However, only 84% of children are currently immunised against these potentially life-threatening illnesses—and that figure fell by 2% after the pandemic.

Vaccine for measles

Measles immunisation rates have fallen to critically low levels. While a 95% coverage rate is required to prevent outbreaks and ensure herd immunity, current first-dose coverage stands at 83%, with second-dose coverage even lower at 74%.

At-risk children

The WHO (World Health Organisation) supported these findings by monitoring measles cases in 100 countries. Nations with over 95% vaccination coverage largely avoided outbreaks, while those below 80% experienced significant and problematic surges.

Tuberculosis and polio

In addition, approximately 15.9 million children have missed their polio vaccinations, and 9.2 million have not received the BCG vaccine, which protects against tuberculosis (TB). Both TB and polio pose serious health risks to young children.

Lack of progress

Unfortunately, global progress in routine immunisation has stalled since 2010, and in some countries, coverage has even declined. For example, the rate of children receiving their first measles dose fell in 100 countries between 2010 and 2020.

Impact of conflict

Conflict is a major factor contributing to low vaccination rates. More than half of unvaccinated children live in one of 31 conflict-affected or fragile states, underscoring the significant challenges these countries face in providing necessary immunisations.

Sudan is at risk

Sudan has experienced one of the sharpest declines in immunisation rates due to violent conflict, with coverage falling by over 20% during one of the country’s most turbulent years.

Disruptions in displacement

Unfortunately, Sudan isn’t the only country affected. Yemen, Afghanistan, and Papua New Guinea have also experienced a rise in unvaccinated children during periods of intense conflict over the past five years. But the issue of limited vaccine access isn’t confined to nations with fragile infrastructure.

Nations that are wealthy

Measles continues to be a global concern, with cases in Europe increasing tenfold in 2024. The United States has also seen a resurgence, rising from near elimination to over 1,000 reported cases by mid-2025.

Declining U.S. immunisation rates

This trend is evident in 21 of the world’s 36 highest-income countries, which have all seen declining rates for at least one major vaccine since 2010—including the US, the UK, and several EU nations.

The EU and the UK

Europe and the UK are now home to approximately 165,000 children who haven’t received a single vaccine. In the UK specifically, childhood immunisation rates have dropped to their lowest level in a decade, with MMR coverage falling as low as 60% in some areas of London.

Return of viruses

The report also revealed a resurgence of diseases like wild poliovirus (WPV) in regions such as Afghanistan, Pakistan, and Papua New Guinea. WPV was the strain responsible for widespread polio outbreaks before the introduction of vaccines.

Gavi intervention

There is some encouraging news—Gavi, the Vaccine Alliance, has been actively supporting countries with limited access to immunisation. Thanks to these efforts, DTP coverage in supported regions of Africa has risen by 1%.

Children in India

India has seen an even more significant improvement, with an 8% increase in children receiving the DTP vaccine in just one year. Still, as one of the world’s most populous nations, the country continues to have around two million children who haven’t received any vaccinations at all.

Vaccine for HPV

The HPV vaccine is one of the few that has shown consistent growth worldwide, with global coverage among girls increasing from 20% to 27% between 2022 and 2023. This vaccine helps protect against the human papillomavirus (HPV).

Gaps in vaccine coverage

Girls face the greatest risk from HPV, as it can cause cervical cancer, and there are significant disparities in prevention efforts between countries. Coverage in high-income nations reaches up to 56%.

Barriers in low-income settings

In low- and middle-income countries, average coverage is much lower—around 23%. Coverage in Gavi-supported countries is even less, at just 16%. However, this figure has doubled from 8% in recent years, indicating a positive trend.

Broadening vaccine access

Overall, the number of vaccines available in each country has grown in recent years, with newer vaccines—such as those for malaria, meningococcal disease, and rotavirus—being introduced in low-income regions.

Immunisation agenda

Despite these advances, significant challenges remain. To address this, the World Health Organisation (WHO) and its partners developed the Immunisation Agenda 2030 (IA2030), aiming to reach 90% global vaccine coverage by 2030.

Future plans

The agenda also targets reducing the number of zero-dose children to 6.5 million by enhancing health services, extending outreach in fragile areas, and increasing investment in primary care and community health workers.

Issues ahead

Misinformation and vaccine hesitancy remain significant challenges. To address this, UNICEF and its partners are advocating for increased investment in health communication, training, and active community engagement to restore trust in vaccines.

Cuts to campaigns

However, reductions in funding for essential organisations like Gavi and national immunisation programs threaten to undermine this progress. As a result, many low-income countries increasingly rely on external aid to sustain their vaccination efforts.

Emergency immunisation

As a result, emergency immunisation campaigns have become essential. However, routine immunisation remains the cornerstone of disease prevention and should not be neglected in favour of emergency efforts.

Prevention is crucial

Experts are urging increased attention to sustainable services capable of delivering routine immunisations. With child vaccination rates declining globally, urgent action is needed to prevent avoidable disease outbreaks.