Childhood Immunization: Global Progress Amid Conflict and Challenges (2026)

Childhood immunization rates have seen a slight improvement globally, with 90% of infants receiving at least one dose of the DTP vaccine and 85% completing the full three-dose series in 2025, according to the WHO-UNICEF Estimates of National Immunization Coverage (WUENIC). However, this progress is overshadowed by the persistent challenges that continue to hinder global vaccination efforts. In my opinion, the fact that global coverage remains one point below 2019 levels is deeply concerning, especially given the significant drop during the COVID-19 pandemic. What makes this particularly fascinating is the stark contrast between the progress made in some regions and the stagnation in others. For instance, the Americas and South-East Asia have fully recovered and improved their performance, with the latter now the highest-performing region. Conversely, Africa, the Eastern Mediterranean, and Europe regions saw gains last year but still fall short of pre-COVID-19 levels. This raises a deeper question: Why are some regions making significant strides while others are struggling to maintain even the modest gains made in recent years? One thing that immediately stands out is the impact of conflict and fragility on immunization programs. More than half of all zero-dose children live in conflict-affected settings, which account for only about a third of the world's child population. In these settings, immunization programs are often strained by political upheaval, insecurity, or chronic underfunding. For example, Syria lost 6 percentage points on DTP1 coverage and 12 points on MCV1 in a single year. However, Sudan recorded the largest single-country gain globally last year, increasing DTP1 coverage by 35 percentage points and lifting MCV1 coverage by 22 points, demonstrating what is possible when access to services improves even amid ongoing conflict. This leads me to speculate that the key to breaking the cycle of stagnation and decline in immunization rates may lie in the ability to adapt and innovate in the face of adversity. In my opinion, the success of Sudan's immunization program highlights the importance of context-specific solutions and the need to invest in strengthening data and disease surveillance systems to drive and guide high-impact immunization program strengthening efforts. What many people don't realize is that the foundations that enabled progress are now under significant strain. The full impact of cuts to international health financing announced over the past two years is not yet reflected in these estimates, but the data systems needed to track that impact and protect against backsliding are themselves showing strain. According to the data, only 18 national immunization surveys were undertaken and submitted this round, down from 50 in 2024 and an average of 33 per year between 2015 and 2019. This is deeply concerning, as weakening investments in the data systems needed to find and reach children who are missing out on vaccines will lead to outbreaks and deaths that could have been prevented. From my perspective, it is clear that we need to take a step back and think about the broader implications of these trends. The fact that global coverage remains one point below 2019 levels, despite the significant drop during the COVID-19 pandemic, suggests that we are not making the progress we need to make to protect the health and well-being of children worldwide. In my opinion, this calls for a renewed commitment from governments and relevant partners to strengthen immunization in conflict and fragile settings, counter false and misleading health information, increase and sustain domestic and global funding for immunization programs and partnerships, and invest in stronger data and disease surveillance systems. Only by addressing these challenges head-on can we hope to make the progress we need to make to ensure that every child, regardless of where they live, has access to the lifesaving protection that vaccines provide.