Routine Vaccination Coverage - Worldwide, 2023

Abstract

In 2020, the World Health Assembly endorsed the Immunization Agenda 2030 (IA2030), a 10-year strategy to reduce vaccine-preventable disease (VPD)-associated morbidity and mortality. IA2030 goals include improving equitable vaccination coverage, halving the number of unimmunized (zero-dose) children, and increasing the introduction of new and underutilized vaccines. The COVID-19 pandemic disrupted health systems worldwide, hindering years of childhood vaccination achievements and putting global public health goals at risk. This report presents trends in World Health Organization (WHO) and UNICEF routine vaccination coverage estimates through 2023 across the 194 WHO member countries. During 2022-2023, global coverage with the first and third doses of diphtheria-tetanus-pertussis-containing vaccine (DTPcv) (89% and 84%, respectively) and the first dose of measles-containing vaccine (83%) stagnated and remained lower than prepandemic levels. The 31 WHO member countries with fragile, conflict-affected, and vulnerable (FCV) settings include approximately one half of the world's 14.5 million children who did not receive the first DTPcv dose. The introduction of new and underutilized vaccines, such as a second MCV dose in the African Region, has improved countries' overall protection against VPDs. Accelerating country-specific routine immunization and catch-up vaccination programs to reach unvaccinated and incompletely vaccinated children, especially those living in FCV settings, is critical to reducing morbidity and mortality associated with VPDs.

FIGURE 1

Estimated number of children who did not receive the first doses of diphtheria-tetanus-pertussis-containing vaccine and measles-containing vaccine, and dropout from the first to third dose of diphtheria-tetanus-pertussis–containing vaccine and from the first dose of diphtheria-tetanus-pertussis–containing vaccine to the first dose of measles-containing vaccine, by World Bank economic classification and World Bank-defined fragile, conflict-affected, and vulnerable settings — worldwide, 2019–2023 Abbreviations: DTPcv = diphtheria-tetanus-pertussis–containing vaccine; DTPcv1 = first DTPcv dose; DTPcv3 = third DTPcv dose; FCV = fragile, conflict-affected, and vulnerable; GNI = gross national income; MCV1 = first measles-containing vaccine dose. * Economic classification is based on GNI per capita, calculated in U.S. dollars (https://datahelpdesk.worldbank.org/knowledgebase/articles/906519-world-bank-country-and-lending-groups). For the current 2025 fiscal year, low-income economies are defined as those with a GNI per capita, calculated using the World Bank Atlas method, of ≤$1,145 in 2023; lower-middle–income economies are those with a GNI per capita of $1,146–$4,515; upper-middle–income economies are those with a GNI per capita of $4,516–$14,005; high-income economies are those with a GNI per capita of >$14,005. ^† FCV is a broad term describing a range of situations, including humanitarian crises, protracted emergencies, and armed conflicts. The 31 countries listed as FCV in 2023 included Afghanistan, Bangladesh, Burkina Faso, Burma, Burundi, Cameroon, Central African Republic, Chad, Colombia, Democratic Republic of the Congo, El Salvador, Ethiopia, Guatemala, Haiti, Honduras, Iraq, Lebanon, Libya, Madagascar, Mali, Mozambique, Niger, Nigeria, Somalia, South Sudan, the Palestinian Territories, Sudan, Syria, Ukraine, Venezuela, and Yemen. https://gho.unocha.org/

FIGURE 2

Estimated number of children who did not receive the first doses of diphtheria-tetanus-pertussis–containing vaccine and measles-containing vaccine, and dropout from the first to third dose of diphtheria-tetanus-pertussis–containing vaccine and from the first dose of diphtheria-tetanus-pertussis–containing vaccine to the first dose of measles-containing vaccine, by World Health Organization region — worldwide, 2019–2023 Abbreviations: DTPcv = diphtheria-tetanus-pertussis–containing vaccine; DTPcv1 = first DTPcv dose; DTPcv3 = third DTPcv dose; MCV1 = first measles-containing vaccine dose. * Based on World Health Organization regional classifications. https://www.who.int/about/who-we-are/regional-offices