India recorded a sharp decline in the number of zero-dose children in 2025, with 6,79,000 children missing all routine vaccinations, according to the World Health Organization (WHO)-UNICEF estimates of National Immunisation Coverage (WUENIC) released on Wednesday.
The figure marks a significant improvement from 9,09,000 in 2024 and 15,92,000 in 2023. Zero-dose children are those who have not received a single routine vaccine because they either lack access to or are not reached by immunisation services.
For the first time since WUENIC estimates were introduced in 2001, India has also moved out of the list of the 10 countries with the highest number of unvaccinated children against measles. Officials said the achievement reflects the country's sustained efforts under the Expanded Programme of Immunisation (EPI) and its commitment to universal vaccination.
To improve vaccine coverage, India has launched focused campaigns targeting zero-dose children in urban slums, migratory populations, hard-to-reach regions and communities affected by vaccine hesitancy. As a result, 95% of children in the country are now fully protected against diphtheria, tetanus and pertussis (DTP3) as well as the second dose of the measles vaccine (MCV2), officials told this paper.
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Global immunisation recovers, but challenges remain
The report said 90% of infants worldwide, or nearly 116 million children, received at least one dose of the diphtheria, tetanus and pertussis (DTP) vaccine in 2025, while 85%, or 110 million, completed the recommended three-dose schedule.
Although both indicators improved by one percentage point compared with 2024, global vaccination coverage remains one percentage point below 2019 levels and has largely stagnated since 2009.
Globally, an estimated 13.5 million children remained zero-dose in 2025, about 7,50,000 fewer than the previous year. However, progress has been offset by a growing number of children who begin vaccination but fail to complete the schedule.
Measles coverage below target despite progress
The report estimates that 7.3 million infants received the first DTP dose but dropped out before receiving their first measles vaccine dose. Consequently, global measles vaccination coverage remained at 84% for the first dose (MCV1) and 77% for the second dose (MCV2), well below the 95% coverage needed to prevent outbreaks.
As a result, 57 countries reported large or disruptive measles outbreaks in 2025.
“Governments and health workers have helped global vaccination rates bounce back after dropping significantly during the COVID-19 pandemic," said UNICEF Executive Director Catherine Russell.
"But millions of vulnerable children are still being left unprotected due to conflict, displacement, and poverty. We must reach every child, and we must rebuild trust where it is fraying. No child should suffer from a disease that a simple vaccine can prevent.”
Data from 195 countries showed that 100 countries have maintained at least 90% coverage with three doses of the DTP vaccine since 2019. Among countries that were below the 90% mark in 2019, 30 have improved over the past six years, while 65 continue to stagnate or decline, including 13 fragile, conflict-affected or vulnerable countries.
Compared with 2019, the Americas and South-East Asia have fully recovered and improved vaccination coverage, with South-East Asia emerging as the best-performing region. Africa, the Eastern Mediterranean and Europe recorded gains but remain below pre-Covid levels, while the Western Pacific experienced a further decline.
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Call for greater investment and stronger immunisation systems
“Every child, whether born into wealth or poverty, peace or conflict, deserves the life-giving protection that vaccines provide. Immunization is one of the most cost-effective, most equitable, and most reliable interventions for protecting children’s health and well-being,” said Dr Tedros Adhanom Ghebreyesus, WHO Director-General.
“Our greatest security begins with ensuring that everyone, wherever they may live, is protected from deadly diseases that vaccines have the power to prevent.”
Over the past 25 years, sustained investments by governments and partners, stronger immunisation programmes, community support and public trust have reduced the annual number of zero-dose children by 40%.
“The historic levels of immunisation that we are seeing across lower-income countries show what can be achieved when all stakeholders work together towards a shared objective,” said Dr Sania Nishtar, CEO of Gavi, the Vaccine Alliance.
“As Gavi heads into a new five-year period, our great challenge now will be to maintain this momentum in the face of funding constraints, geopolitical uncertainty, and increasing outbreaks – while working harder to reach those children who still do not have access to immunisation.”
WHO, UNICEF and Gavi said the world remains off track to achieve the Immunisation Agenda 2030 target of reducing the number of zero-dose children. They called on governments and partners to strengthen immunisation services in conflict-affected and fragile settings, counter false and misleading health information, increase domestic and global funding for vaccination programmes, and invest in stronger data and disease surveillance systems to improve immunisation coverage.
