Health leaders have sounded the alarm over conflicts hindering global child vaccination efforts, with recent data revealing that approximately 14.5 million children have not received a single immunization dose.
According to figures from the UN Children’s Agency (UNICEF) and the World Health Organization (WHO), more than half of these children reside in countries plagued by armed conflicts or other humanitarian crises. These crises have created fragile and vulnerable situations, severely impacting vaccination campaigns.
The war in Sudan has dramatically increased the number of unvaccinated children, soaring from around 110,000 in 2021 to an estimated 701,000 last year. Yemen also saw a rise, with 580,000 unvaccinated children, up from 424,000 three years ago.
In 2023, in addition to the 14.5 million “zero-dose” children, another 6.5 million were “under-vaccinated,” meaning they had not received all their recommended doses. These figures have risen since 2022, raising concerns among officials who warn that the international goal to halve the number of zero-dose children by 2030 is off-track.
Dr. Katherine O’Brien, director of the WHO’s immunization and vaccines department, stated, “This puts the lives of the most vulnerable children at risk.” She highlighted that children in humanitarian settings also face a lack of security, nutrition, and healthcare, making them more likely to die from vaccine-preventable diseases.
Global vaccine coverage has not yet returned to 2019 levels, before the COVID-19 pandemic disrupted immunization programs. In 2019, 12.8 million children were classified as zero-dose, and 5.5 million were under-vaccinated.
More than half of the world’s zero-dose children live in just ten countries, characterized by large birth cohorts and weak health systems. These countries include Nigeria, India, the Democratic Republic of the Congo, and Indonesia. In 2023, Sudan, Yemen, and Afghanistan joined this list.
Douglas Hageman, UNICEF’s Sudan representative, described the collapse of the country’s health system during the war. “National vaccination coverage has plummeted from 85% before the war to around 50% currently, with rates averaging 30% in active conflict areas and as low as 8% in South Darfur,” he said. Outbreaks of vaccine-preventable diseases such as measles, rubella, and polio have become common, Hageman added.
Vaccination rates in Yemen are “alarmingly low,” according to Peter Hawkins, UNICEF’s representative in the country. “A combination of factors, including lack of access to healthcare, vaccine hesitancy, and worsening socioeconomic and political crises, have exacerbated the situation,” he said.
O’Brien warned that misinformation spread during the pandemic continues to affect many countries and result in deaths. Despite these challenges, the UN report noted a significant increase in coverage of the HPV vaccine, which can protect against cervical cancer. However, the vaccine still needs to be introduced in 51 countries, including China and India.
