Millions of children globally are facing increased risks due to the stagnation of vaccination efforts in recent years. An in-depth analysis published in the Lancet medical journal highlights the concerning trend, revealing that while the World Health Organization’s (WHO) global vaccination program has achieved significant milestones since its inception in 1974—reaching over 4 billion children and saving 154 million lives—the momentum has faltered in recent decades.
The study outlines that although global coverage for essential vaccines, including those against measles, polio, and tuberculosis, nearly doubled between 1980 and 2023, the progress has slowed considerably from 2010 to 2019. In some regions, vaccination rates have even declined in recent years. Alarmingly, this trend extends to wealthier nations, where at least one key vaccine has seen a decrease in 21 of 36 high-income countries and territories.
The authors of the study emphasize that the COVID-19 pandemic has exacerbated these challenges. Since 2020, global vaccination rates have significantly dropped and have yet to recover to pre-pandemic levels as of 2023. This downturn has resulted in tens of millions of children missing essential doses of routine vaccines, ultimately heightening their risk for preventable diseases and premature death.
Despite the considerable efforts made over the past 50 years, significant numbers of children remain under-vaccinated or unvaccinated. Senior study author Jonathan Mosser from the University of Washington’s Institute for Health Metrics and Evaluation stated, “Routine childhood vaccinations are among the most powerful and cost-effective public health interventions available.” He pointed out that persistent global inequalities, the challenges posed by the COVID pandemic, and the rise of vaccine misinformation and hesitancy have all contributed to this stagnation in immunization progress.
These concerning trends have led to outbreaks of vaccine-preventable diseases, such as measles, polio, and diphtheria, in several countries. Kate O’Brien, WHO director for immunization, vaccines, and biologicals, expressed that despite the notable advancements brought about by vaccines, “we are now confronting a painful reality: Progress has stalled and in some countries is being lost.” She urged for intensified efforts to reach more children through equitable routine immunization programs.
The study also highlights conflict as a significant barrier to vaccination, citing the civil war in Sudan in 2023, which caused the coverage of the DTP vaccine (against diphtheria, tetanus, and pertussis) to plummet from nearly 90% to around 50%. Furthermore, planned budget cuts to vaccination programs are likely to disproportionately affect low- and middle-income countries, but even wealthier nations may face increased costs due to rising outbreaks.
The findings of this study echo warnings from WHO Director-General Tedros Adhanom Ghebreyesus, who cautioned that increasing outbreaks of vaccine-preventable diseases threaten lives and impose higher costs on countries in treating illnesses and managing outbreaks. He stressed the importance of investing in high-impact interventions, including vaccines.
Domestically, the situation is dire as well. Following the deaths of two children from measles in Texas, the U.S. has recorded 23 outbreaks with over 1,000 confirmed cases. Controversies surrounding vaccine messaging have emerged, with figures like Health and Human Services Secretary Robert F. Kennedy Jr. making mixed statements regarding measles immunization.
Experts emphasize that public trust is crucial for successful vaccination campaigns. David L. Heymann, a professor at the London School of Hygiene and Tropical Medicine, highlighted the need for governments to communicate effectively and provide evidence-based recommendations from trusted organizations like the U.S. Centers for Disease Control and Prevention.
Sir Andrew Pollard, director of the Oxford Vaccine Group, referred to the study's findings as a “worrying trend” that is likely to deteriorate amid cuts to global health funding. He criticized the previous U.S. administration for actions that undermined public confidence in vaccines, warning that this, combined with diminished global health funding and challenges to scientific leadership in vaccination policy, poses significant risks for future immunization efforts.
