Routine Vaccination Coverage - Worldwide, 2023

In 2020, the World Health Assembly endorsed the Immunization Agenda 2030 (1A2030), a 10-year strategy to reduce vaccine-preventable disease (VPD)-associated morbidity and mortality. IA2030 goals include improving equitable vaccination coverage, halving the number of unimmunized (zero-dose) children, and increasing the introduction of new and underutilized vaccines. The COVID-19 pandemic disrupted health systems worldwide, hindering years of childhood vaccination achievements and putting global public health goals at risk. This report presents trends in World Health Organization (WHO) and UNICEF routine vaccination coverage estimates through 2023 across the 194 WHO member countries. During 2022-2023, global coverage with the first and third doses of diphtheria- tetanus-pertussis-containing vaccine (DTPcv) (89% and 84%, respectively) and the first dose of measles-containing vaccine (83%) stagnated and remained lower than prepandemic levels. The 31 WHO member countries with fragile, conflict-affected, and vulnerable (FCV) settings include approximately one half of the world's 14.5 million children who did not receive the first DTPev dose. The introduction of new and underutilized vaccines, such as a second MCV dose in the African Region, has improved countries' overall protection against VPDs. the 2021-2030 overarching global vision and strategy to reduce morbidity and mortality from vaccine-preventable diseases (VPDs) across the life course and leave no one behind (3). Goals of this strategy include improving equitable vaccination coverage, halving the number of zero-dose children (children who have not received the first dose of a diphtheria-tetanus-pertussis-containing vaccine [DTPev]), and increasing introductions of new and underutilized vaccines. Progress was adversely affected by the COVID-19 pandemic, as impeded access to health services resulted in global declines in immunization coverage and a nearly 40% increase in the number of zero-dose children (4), increasing immunity gaps worldwide. This report updates a previous report (5) and presents global, regional, and national routine vaccination coverage trends during 2010-2023 across the 194 WHO member countries, highlighting trends before and during the COVID-19 pan- demic, and through 2023.