Child vaccination against potentially deadly diseases is declining worldwide due to persistent economic inequalities, COVID-19-related disruptions, and the spread of misinformation about vaccines, putting millions of lives at risk, according to a study published Wednesday.
The study, a global overview of childhood vaccination rates between 1980 and 2023 and published in The Lancet, provides updated estimates for 204 countries and territories ahead of the Gavi donor conference in Brussels on Wednesday.
The past 50 years have seen unprecedented progress, and the World Health Organization's core immunization program has saved the lives of some 154 million children. Vaccination coverage against diseases such as diphtheria, tetanus, pertussis, measles, polio, and tuberculosis doubled globally between 1980 and 2023, the researchers noted.
However, "these long-term achievements belie recent challenges and significant disparities," according to the study.
Measles vaccination coverage declined between 2010 and 2019 in nearly half of all countries, particularly in Latin America and the Caribbean, and the proportion of children receiving at least one dose of DTP, measles, polio, or tuberculosis vaccines declined in most wealthy countries.
Then the COVID-19 pandemic exacerbated these challenges.
However, "this long-term progress belies recent challenges and significant disparities," according to the study.
An example of this impact is that between 2020 and 2023, an additional 13 million children missed out on any vaccine dose, and an estimated 15.6 million missed out on all three doses of diphtheria, tetanus, pertussis (DTP) or measles vaccines.
Significant gaps remain, particularly at the expense of the poorest countries. In 2023, more than half of the world's 15.7 million unvaccinated children lived in just eight countries, primarily in sub-Saharan Africa and South Asia.
"Routine childhood vaccination is one of the most effective and cost-effective public health interventions," said Jonathan Moser, lead author of the study and a member of the US Institute for Health Metrics and Evaluation (IHME).
"But persistent global inequalities, the challenges posed by the COVID pandemic, and increasing misinformation and vaccine hesitancy have all contributed to undermining vaccination progress," he added in a statement.
“Add to this the growing number of displaced people and the exacerbation of inequalities caused by armed conflict, political volatility, economic instability, and climate crises,” said Emily Hauser, another study author and a researcher at the Institute for Health Metrics and Evaluation (IHME).
As a result, outbreaks of vaccine-preventable diseases are on the rise around the world, putting lives at risk and placing affected countries incurring increased disease response costs.
The European Union recorded 10 times more measles cases in 2024 than in 2023, and the United States surpassed 1,000 confirmed cases last month, far more than in all of 2023. Increasing numbers of polio cases, a disease long eradicated in many countries thanks to vaccination, have also been reported in Pakistan and Afghanistan, while Papua New Guinea is experiencing a new outbreak.
All these setbacks could hinder the achievement of the WHO's global immunization targets for 2030, which include vaccinating 90% of children and adolescents with basic vaccines.
The WHO also aims to halve the number of children under one year old who have not received any dose of the diphtheria, tetanus, and pertussis vaccine compared to 2019. So far, only 18 countries have achieved this goal, according to a study funded by the Gates Foundation and the Global Alliance for Vaccines (Gavi).
Meanwhile, the global health sector has been facing disruptions since the drastic cuts in US international aid approved by the Trump administration in early 2025.
"For the first time in decades, the number of children dying worldwide this year is likely to increase rather than decrease," Bill Gates said in a separate statement on Tuesday.
"This is a tragedy," the Microsoft co-founder added, pledging $1.6 billion to Gavi during the conference. His foundation also contributes funding to the World Health Organization and the International Polio Alliance.
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