An estimated 13.5 million “zero-dose” children, including 679,000 in India, did not receive a single vaccine in their first year in 2025, according to the annual WHO-UNICEF Estimates of National Immunization Coverage (WUENIC) released on Wednesday. Nigeria topped the chart with 2.2 million unvaccinated children.
The report said 90% of infants globally, or nearly 116 million, received at least one dose of a diphtheria, tetanus, and pertussis (DTP) vaccine, and 85% (110 million) completed the full three-dose series. Both indicators rose by one percentage point from the previous year. But global coverage remains one point below 2019 levels, hovering within the same narrow range since 2009.
The “zero-dose” children figures represent nearly 750,000 fewer children than the previous year, the report said. It added that the progress is offset by a rising number of children who start the schedule and do not complete it.
The report said most of unvaccinated children live in countries where national immunisation programmes receive support from Gavi, the Vaccine Alliance.
Globally, 7.3 million infants are estimated to have received their first DTP dose but dropped out before receiving their first measles dose. This drop-out rate contributed to stalled measles coverage, with 84% of children receiving the first measles dose (MCV1) and 77% receiving the second dose (MCV2). Both figures fall far short of the 95% threshold required to prevent outbreaks of this highly contagious virus. Also, 57 countries reported large or disruptive measles outbreaks in 2025.
“Governments and health workers have helped global vaccination rates bounce back after dropping significantly during the COVID-19 pandemic,” said Unicef executive director Catherine Russell. “But millions of vulnerable children are still being left unprotected due to conflict, displacement, and poverty. We must reach every child, and we must rebuild trust where it is fraying. No child should suffer from a disease that a simple vaccine can prevent.”
Data from 195 countries show that 100 countries have maintained at least 90% coverage with three doses of the DTP vaccine since 2019, with little progress in expanding this group. Of the countries below 90% coverage in 2019, 30 improved their rates over the past six years. But 65 countries are stagnating or falling behind, including 13 fragile, conflict-affected or vulnerable countries.
The report highlights an alarming trend that in middle- and high-income countries, even where vaccines are fully accessible, coverage is slipping 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. Immunisation is one of the most cost-effective, most equitable, and most reliable interventions for protecting children’s health and well-being,” said WHO director-general Tedros Adhanom Ghebreyesus. “Our greatest security begins with ensuring that everyone, wherever they may live, is protected from deadly diseases that vaccines have the power to prevent.”
The report said WHO and Unicef are working with Gavi and other partners to deliver the global Immunisation Agenda 2030 goal to ensure vaccines reach everyone, everywhere, at every age.
