A newly released report by the World Health Organization and the United Nations Children’s Fund has revealed that approximately 14.3 million children worldwide remain entirely unvaccinated.
CNN reported that global health experts are sounding the alarm, warning that rising conflict and misinformation are threatening gains in childhood immunization.
Each year, WHO and UNICEF compile national immunization estimates using data from 195 countries. Their 2024 report, published Monday, indicates modest improvements in routine vaccinations, but millions of children remain at risk for diseases that are preventable with vaccines.
According to the findings, 171,000 more children received vaccines last year compared to 2023. However, over 14 million still missed all vaccinations, and an additional 5.7 million received only partial doses of recommended vaccine series.
“The latest estimates highlight a really concerning trajectory,” said Dr. Kate O’Brien, WHO’s Director of the Department of Immunization, Vaccines and Biologicals, during a media briefing.
“The global vision is for everyone everywhere to benefit from lifesaving vaccines,” she added. “But we’ve hit this very stubborn glass ceiling, and breaking through that glass to protect more children against vaccine-preventable diseases is becoming more difficult.”
Armed conflict and political instability continue to obstruct immunization campaigns, especially in low- and middle-income nations. Children in conflict-affected areas are the hardest hit.
“Children living in one of 26 countries affected by fragility, conflict or humanitarian emergencies are three times more likely to be unvaccinated compared to children who live in stable countries,” O’Brien explained. “In fact, half of all children unvaccinated in the world live in these fragile, vulnerable and conflict countries.”
Nine countries, Nigeria, India, Sudan, the Democratic Republic of Congo, Ethiopia, Indonesia, Yemen, Afghanistan, and Angola, were responsible for more than half of the world’s completely unvaccinated children in 2023.
Meanwhile, some high-income nations are seeing a dip in vaccine uptake due to hesitancy and institutional distrust, leading to a resurgence in diseases like measles and polio.
“Based on all we know, over the past 50 years, over 150 million lives were saved through vaccination, and this has been able to protect children from any forms of vaccine-preventable diseases,” noted Dr. Ephrem Lemango, UNICEF’s Associate Director for Health and Global Chief of Immunization.
“But misinformation and any forms of vaccine hesitance is a reflection of a broader lack of trust or mistrust in the systems that deliver the vaccines, in the health workers that provide the vaccines and in the manufacturing facilities or the ecosystems that manufacture the vaccines,” Lemango added. “So it is important to see misinformation or lack of information as part of a broader ecosystem to be able to address.”
O’Brien emphasized that misinformation, while a growing issue, is not the primary driver of low vaccination numbers globally.
“There are communities sort of hidden under that national number that have very low vaccination coverage, and that’s where outbreaks are happening, and those children are the ones who are suffering,” she said.
In the United States, for instance, measles cases have spiked to their highest levels in 25 years, with the majority traced back to under-vaccinated regions, such as West Texas.
“The main reason, when you look worldwide, why children aren’t vaccinated is because of access to vaccines and access to vaccination services and this is where it’s particularly important,” O’Brien noted.
“They’re not being vaccinated because they don’t have access,” she continued. “They’re in dangerous settings, it’s hard to gain access to them, and in some situations, the government does not have access to those environments.”
WHO Director-General Dr. Tedros Adhanom Ghebreyesus also warned that declining international aid and the spread of misinformation risk undermining decades of vaccination progress.
“We still have a lot of work to do,” Tedros said in a statement. “Drastic cuts in aid, coupled with misinformation about the safety of vaccines, threaten to unwind decades of progress. WHO remains committed to working with our partners to support countries to develop local solutions and increase domestic investment to reach all children with the lifesaving power of vaccines.”
The report detailed vaccine coverage trends for 2024, noting steady progress in some areas. Coverage of the DTP vaccine (against diphtheria, tetanus, and pertussis) remained stable with 89% of infants receiving the first dose, and 85% completing all three doses, similar to the previous two years.
First-dose measles vaccine coverage held at 84%, slightly below pre-pandemic levels of 86% in 2019. Overall, 20.6 million children missed this routine shot in 2024.
On a brighter note, the number of children receiving the second measles dose rose to 76%, up from 74% in 2023 and 73% in 2022.
In the United States, vaccine hesitancy continues to fuel preventable disease outbreaks. More than 90% of confirmed measles cases this year were among individuals who were either unvaccinated or whose vaccination status was unknown, according to the CDC.
UNICEF Executive Director, Catherine Russell, stressed the urgent need to overcome the various barriers that stand in the way of reaching more children.
“The good news is that we have managed to reach more children with life-saving vaccines. But millions of children remain without protection against preventable diseases, and that should worry us all,” she said.
“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.”
Despite the challenges, one area of notable progress is in HPV vaccine coverage, particularly among girls. The report shows that 31% of girls received their first HPV dose in 2024, up from 27% in 2023 and 20% in 2022.
Completion rates also improved significantly, with 28% receiving all recommended doses compared to 21% in 2023 and 14% in 2022.
“This is a real bright spot in the data that, again, year on year now, we’re seeing increases in HPV vaccine coverage,” O’Brien said. She credited much of the increase to vaccine rollouts in Nigeria, Bangladesh, and several other countries.
Coverage among boys remained unchanged, with 8% receiving their first HPV dose in both 2023 and 2024.
Summing up the findings, Dr. Dan Barouch, Director of the Center for Virology and Vaccine Research at Beth Israel Deaconess Medical Center, who was not involved in the study, emphasized the urgency of the situation.
“Fourteen million children who have received no vaccines is 14 million too many. Childhood vaccination is one of the most cost-effective medical interventions that’s ever been developed,” Barouch said. “I would hope that global health authorities prioritize childhood vaccination programs and that funding mechanisms are developed to ensure the continuation of these programs.”
