The United Nations has warned that more than 13 million children around the world missed all routine vaccinations last year, with progress towards immunization targets being too slow. According to estimates from the World Health Organization (WHO) and UNICEF, there were 13.5 million so-called ‘zero-dose’ children in 2025, with more than half living in sub-Saharan Africa. Nigeria accounted for the largest number globally, followed by the Democratic Republic of Congo, Yemen, Ethiopia, and Angola among the ten worst-affected countries.
The number of zero-dose children has dropped from 14.2 million in the previous year, but remains higher than before the COVID-19 pandemic. It is also almost four million above the 2025 milestone needed to meet the global goal of halving the number of unvaccinated children by 2030. Dr. Ephrem Lemango, UNICEF’s Associate Director for Health and Global Chief of Immunization, stated that ‘the pace of reduction is too slow to reach the goals by the end of the decade.’
Despite the improvement, Dr. Lemango noted that progress remains uneven, with 74 countries having more zero-dose children in 2025 than in 2019. Conflict is one of the biggest barriers, leaving millions beyond the reach of routine health services. More than half of the world’s zero-dose children now live in fragile and conflict-affected settings, which account for only around a third of the world’s births.
Yemen recorded the world’s lowest coverage for the first dose of the diphtheria, tetanus, and pertussis (DTP1) vaccine, while Nigeria had the world’s largest number of completely unvaccinated children due to low immunization coverage and a large birth cohort. Rapid population growth in many low-income African nations also means health services must vaccinate ever-larger numbers of children simply to maintain existing coverage.
The UN expressed concern about falling vaccination rates in some middle- and high-income countries, blaming governance challenges, declining political commitment, and growing vaccine misinformation. The findings also come amid growing concern over the resurgence of measles, with 97 countries experiencing large or disruptive measles outbreaks during the past five years, generally having substantially lower routine immunization coverage.
However, Dr. Lemango pointed to Sudan, which recorded the largest improvement reported anywhere in the world last year, as evidence that progress is still possible even during war. The UN warned that this level of coverage could be the best seen, as the 2025 data sets do not yet show the impact of international funding cuts, which were announced after most vaccination programs had already received their funding for the year.
