Current Status + Progress
Despite major progress, the full potential of immunization continues to elude many of the world’s children

Immunization is one of the most cost-effective public health interventions to date, saving millions of lives1 and protecting countless children from illness and disability. As a direct result of immunization, polio is on the verge of eradication. Deaths from measles, a major child killer, declined by 79 per cent worldwide and by 86 per cent in sub-Saharan Africa between 2000 and 20142. And as of August 2015, 38 of 59 priority countries have eliminated maternal and neonatal tetanus. Immunization coverage for the six major vaccine-preventable diseases – pertussis, childhood tuberculosis, tetanus, polio, measles and diphtheria – has risen significantly since the Expanded Programme on Immunization began in 1974. The percentage of children receiving diphtheria, tetanus and pertussis (DTP) containing vaccine is often used as an indicator of how well countries are providing routine immunization services. Global coverage for the third dose of DTP increased from 21 per cent in 1980 to 72 per cent in 2000 to an estimated 86 per cent by the end of 2015. Nevertheless, global coverage of DTP3 has stalled during the last decade and immunization has not yet realized its full potential.


Global immunization 1980-2015, coverage of the third dose of DTP containing vaccine
Global coverage the third dose of DTP-containing vaccine at 86% in 2015

Source: WHO/UNICEF estimates of immunization coverage 2015

Globally, 126 countries achieved the target coverage of 90 per cent for the third dose of DTP during 2015. Still 68 countries are yet to reach the immunization target of the Global Vaccine Action Plan (GVAP) of achieving 90 per cent or more of DTP3 coverage at the national level.

Number of countries that reached and sustained 90% coverage for the third dose of DTP containing vaccines since 2000 and global DTP3 coverage

Source: WHO/UNICEF estimates of immunization coverage 2015

Conflicts along with under-investments in national immunization programmes, vaccine stock-outs and disease outbreaks are some of the main factors preventing many countries from maintaining the strong health systems that are needed to sustainably deliver vaccination services. Six countries had less than 50 per cent coverage of DTP3 in 2015, many of which are in fragile states or affected by emergencies: Central African Republic, Equatorial Guinea, Somalia, South Sudan, Syrian Arab Republic and Ukraine.

Countries with less than 50% coverage of DTP3 or MCV1, 2015

Source: WHO/UNICEF estimates of immunization coverage 2015

As of the end of 2015, 19.4 million children under 1 year of age worldwide had not received the recommended third dose of DTP, and 20.3 million children in the same age group had failed to receive a single dose of measles-containing vaccine. Given an estimated annual cohort of 135.5 million surviving infants, an additional 5.4 million children would need to have been reached during 2015 to attain 90 per cent DTP3 coverage globally.

Number of unvaccinated infants by year and UNICEF regions, 2000-2015 (third dose of DTP containing vaccine)

Source: WHO/UNICEF estimates of immunization coverage 2015

More than half of the unvaccinated children live in six countries and ten countries (Democratic Republic of Congo, Ethiopia, India, Indonesia, Iraq, Nigeria, Pakistan, Philippines, Uganda and South Africa) host 60 per cent of the total number of children who did not received the third dose of DTP containing vaccine. Other populous developing countries, because of their large age cohort, may contribute significantly to the number of children unvaccinated even if they enjoy fairly high rates of immunization coverage. Efforts to raise global immunization levels will require a strong focus on the countries where the highest numbers of unvaccinated children live – while also ensuring that the countries where children are most likely to miss out on immunization are not neglected in the search for greater global impact.

Countries with the most unvaccinated infants, 3rd dose of DTP containing vaccines, 2013-2015 (in millions)

Source: WHO/UNICEF estimates of immunization coverage 2015

An increasing number of countries are now offering pneumococcal conjugate vaccine (128 countries as of September 2015) and rotavirus vaccine (81 countries as of September 2015) in their immunization programmes, thus offering protection against pneumonia and diarrhoea. Use of underutilized vaccines, such as those against yellow fever and Japanese encephalitis, have also been expanded. UNICEF and the World Health Organization (WHO) have broadened their monitoring process accordingly to include coverage of all of these vaccines. Vaccine introduction is especially lagging in middle income countries. These countries are often not able to finance introduction with national resources, while they generally do not have access to external funding sources. Low-income-countries have largely been able to close the gap in coverage with assistance from Gavi, the Vaccine Alliance.

Pneumococcal Conjugate Vaccine (PCV) introduced in 128 countries; coverage by income status, 2008-2015

Source: WHO/UNICEF estimates of immunization coverage 2015

Rotavirus vaccine introduced in 81 countries; coverage by income status, 2015

Source: WHO/UNICEF estimates of immunization coverage 2015


The Global Vaccine Action Plan (GVAP) was endorsed by 194 Member States of the World Health Assembly in May 2012 to achieve the vision of universal access to immunization outlined in the Decade of Vaccines. The action plan is a framework to prevent millions of deaths by 2020 and beyond by:

  • Strengthening routine immunization to meet vaccination coverage targets
  • Accelerating control of vaccine-preventable diseases with polio eradication as the first milestone
  • Introducing new and improved vaccines
  • Spurring research and development for the next generation of vaccines and technologies.

Progress on the Global Vaccine Action Plan is reported annually to the World Health Assembly and began in 2014. The Global Vaccine Action Plan builds on the Global Immunization Vision and Strategy 2006─2015, developed by UNICEF, WHO and partners to assist countries in expanding the reach of immunization to every eligible person, including those in age groups beyond infancy. One of its goals is to attain and sustain immunization coverage of 90 per cent at the national level and 80 per cent at the district level or equivalent administrative unit. The target year for achieving these coverage levels for DTP3 is 2015, whereas for other vaccines in the national programme the target is by 2020.  At the end of 2015, 68 countries did not reach the goal of achieving 90 per cent or more of DTP3 vaccination coverage at the national level and even more did not achieve the goal at the district level. Substantial effort and game changing strategies in fragile countries will need to be implemented successfully in order to meet the GVAP 2020 goals.

For further details on the Global Vaccine Action Plan and current progress, visit the GVAP Secretariat.


Gavi, the Vaccine Alliance, has developed financial sustainability plans for countries eligible for support. But mobilizing and securing adequate funding will also require stronger political will, better management and greater advocacy. Increases in routine coverage and improved availability of new vaccines can succeed in reducing child deaths, even in the poorest countries and under difficult circumstances. Strategies to reach every district include re-establishing outreach services, building district-level micro-planning, providing supportive supervision, linking communities with services, and strengthening the health systems by making them more resilient to external chocks such as outbreaks and improving their human resource capacity.

Campaigns such as those for polio eradication and measles mortality reduction have helped strengthen the cold chain and injection safety. Support from Gavi for the introduction of new vaccines, including training, demand-creation and cold-chain expansion, is helping boost immunization activities. Greater attention is also being focused on improving the availability, retention and utilization of home-based vaccination records (vaccination cards). Such records play an important role in documenting immunization services received by individuals. When properly used, they provide a relatively inexpensive and effective instrument for promoting childhood immunization, educating caregivers about their child’s immunization status and stimulating demand for services.  UNICEF and WHO in collaboration with partners are working with national immunization programmes to improve the availability, utilization and retention of home-based records. An online library,, has been established to facilitate review and exchange of information on existing vaccination and child health cards, and a website has been developed to monitor their prevalence through household surveys. WHO has also developed a Practical Guide for the Design, Use and Promotion of Home-Based Records in Immunization. In addition, in the coming years, a substantial effort will be needed to engage human resources to achieve the GVAP targets. In 2014, the World Health Assembly recognized that the health goal and its 13 health targets – including a renewed focus on equity and universal health coverage – would only be attained through substantive and strategic investment in the global health workforce.



  1. Levine, O.S., et al., ‘The Future of Immunisation Policy, Implementation, and Financing’, Lancet, vol. 378, 2011, pp. 439─448.
  2. Perry, R., et al., “Progress towards regional measles elimination, worldwide, 2000–2014”, Weekly Epidemiological Record, No. 46, 13 November 2015, pp. 623-631
Access The Data
Immunization Coverage and System Performance Indicator Data
Immunization coverage by antigen (including trends)Download Data
System Performance Indicator Survey DataDownload Data
Sample of the WHO/UNICEF Joint Reporting Form on Immunization in EnglishDownload Data
Sample of the WHO/UNICEF Joint Reporting Form on Immunization in SpanishDownload Data
Sample of the WHO/UNICEF Joint Reporting Form on Immunization in FrenchDownload Data
Progress and Challenges
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Immunization coverage by antigen (global and regional)Download Data
Recent Resources
Country Profiles

Immunization Country Profiles

Aug 1, 2016

Immunization is one of the most cost-effective public health interventions to date, saving millions of lives and protecting countless children from illness and disability. These statistical profiles based on WHO/UNICEF joint estimates of national immunization coverage (WUENIC), present summaries of the latest data at the country level.

Journal Article

Results from a survey of national immunization programmes on home-based vaccination record practices in 2013

Feb 10, 2015

During January 2014, WHO and the United Nations Children’s Fund sent a one-page questionnaire to 195 countries to obtain information on HBRs including type of record used, number of records printed, whether records were provided free-of-charge or required by schools, whether there was a stock-out and the duration of any stock-outs that occurred, as well as the total expenditure for printing HBRs during 2013.

Access article (PDF)

Immunization Summary: A statistical reference containing data through 2013

Nov 10, 2014

This immunization summary is a statistical reference containing data through 2013. It was jointly produced by the United Nations Children’s Fund (UNICEF) and the World Health Organization (WHO). It presents detailed statistics on the performance of national and district-level immunization systems in 195 countries and territories.

Download Immunization Summary (PDF)
Web Application

Immunization Coverage Summary Application

Nov 1, 2014

The Immunization Summary is an app for visualizing (tables, graphs, maps) data on policies, activities and impact of national immunization systems. These data are reported by WHO & UNICEF member states annually for incidence, coverage and immunization indicators. The WHO UNICEF estimates of national immunization coverage constitute an independent technical assessment of coverage. The population data are provided by the United Nations’ Population Division’s “World Population Prospects – The 2012 Revision.” With the exception of the infant and child mortality figures which are provided by WHO’s “World Health Statistics 2014,” data for 2013. The GNI & GDP data are taken from the “2015 World Bank Development Indicators” online. Data are available from 1980 to 2014 (as of 14 July 2015) for a 195 countries or territories.

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Journal Article

A Summary of Global Immunization Coverage through 2013

Aug 14, 2014

This paper summarizes the 2013 revision (completed July 2014) of the WHO and UNICEF estimates of national immunization coverage (WUENIC).

Download article (PDF)
Country Specific Reports and Notes on the Data

Country-specific reports of the WHO and UNICEF estimates of national immunization coverage

The graphs and data tables displayed in the country-specific reports show the national coverage levels for each vaccine for the period from 2003 through 2014 (see guide). Owing to evolving methodology and revisions of the time series, the data in each revision supersede all historical data previously published.

To access country data please click on country name

Central and Eastern Europe and the Commonwealth of Independent States

Albania Georgia Serbia
Armenia Kazakhstan Tajikistan
Azerbaijan Kyrgyzstan The former Yugoslav Republic of Macedonia
Belarus Montenegro Turkey
Bosnia and Herzegovina Republic of Moldova Turkmenistan
Bulgaria Romania Ukraine
Croatia Russian Federation Uzbekistan

East Asia and the Pacific

Brunei Darussalam Lao People’s Democratic Republic Palau Timor-leste
Cambodia Malaysia Papua New Guinea Tonga
China Marshall Islands Philippines Tuvalu
Cook Islands Micronesia Federated States of Republic of Korea Vanuatu
Democratic People’s Republic of Korea Mongolia Samoa Viet Nam
Fiji Myanmar Singapore
Indonesia Nauru Solomon Islands
Kiribati Niue Thailand

Eastern and Southern Africa

Angola Kenya Namibia Swaziland
Botswana Lesotho Rwanda United Republic of Tanzania
Burundi Madagascar Seychelles Uganda
Comoros Malawi Somalia Zambia
Eritrea Mauritius South Africa Zimbabwe
Ethiopia Mozambique South Sudan

Industrialized countries

Andorra France Lithuania Slovakia
Australia Germany Luxembourg Slovenia
Austria Greece Malta Spain
Belgium Hungary Monaco Sweden
Canada Iceland Netherlands Switzerland
Cyprus Ireland New Zealand United Kingdom
Czech Republic Israel Norway United States
Denmark Italy Poland
Estonia Japan Portugal
Finland Latvia San Marino

Latin America and the Caribbean

Antigua and Barbuda Costa Rica Haiti Saint Lucia
Argentina Cuba Honduras Saint Vincent and the Grenadines
Bahamas Dominica Jamaica Suriname
Barbados Dominican Republic Mexico Trinidad and Tobago
Belize Ecuador Nicaragua Uruguay
Bolivia (Plurinational State of) El Salvador Panama Venezuela (Bolivarian Republic of)
Brazil Grenada Paraguay
Chile Guatemala Peru
Colombia Guyana Saint Kitts and Nevis

Middle East and North Africa

Algeria Jordan Qatar United Arab Emirates
Bahrain Kuwait Saudi Arabia Yemen
Djibouti Lebanon State of Palestine
Egypt Libya Sudan
Iran (Islamic Republic of) Morocco Syrian Arab Republic
Iraq Oman Tunisia

South Asia

Afghanistan Maldives
Bangladesh Nepal
Bhutan Pakistan
India Sri Lanka

West and Central Africa

Benin Democratic Republic of the Congo Mali
Burkina Faso Equatorial Guinea Mauritania
Cabo Verde Gabon Niger
Cameroon Gambia Nigeria
Central African Republic Ghana Sao Tome and Principe
Chad Guinea Senegal
Congo Guinea-Bissau Sierra Leone
C�te d’Ivoire Liberia Togo

Since June 2000, WHO and UNICEF have conducted annual reviews of national immunization coverage. Immunization coverage estimates are used for a variety of purposes: to monitor the performance of immunization services at local, national and international levels; to guide polio eradication, measles control and maternal and neonatal tetanus elimination; to identify areas of weak system performance that may require extra resources and focused attention; and as one indicator when deciding whether to introduce a new vaccine. Coverage levels with diphtheria-tetanus-pertussis-containing vaccine (DTP) are considered one indicator of health system performance.

A detailed explanation of the methods behind the WHO and UNICEF estimates of national immunization coverage is provided elsewhere.1,2,3,4 Estimates of immunization coverage are generally based on two sources of empirical data: reports of vaccinations performed by service providers (administrative data5) and household surveys containing items on children’s vaccination history (coverage surveys).  For estimates based on administrative data, the immunization coverage is derived by dividing the total number of vaccinations given by the number of children in the target population.  For most vaccines the target population is the national annual number of births or number of surviving infants (this may vary depending on countries’ policies and the specific vaccine). Immunization coverage surveys are frequently used in connection with administrative data. The Expanded Programme on Immunization (EPI) 30-cluster survey, the UNICEF-supported Multiple Indicator Cluster Surveys (MICS) and the Demographic Health Surveys (DHS) supported by the United States Agency for International Development are the principal surveys used as sources of information on immunization coverage.

This review relies on the following data:

  • Officially reported data by WHO and UNICEF Member States
  • A historical database maintained by UNICEF
  • Nationally representative, population-based household survey reports (published and unpublished).

It is important to distinguish whether data accurately reflect immunization system performance or whether they are compromised and thus present a misleading view of immunization coverage.  Officially reported data are therefore compared with independent surveys.  Based on the data available, the consideration of potential biases and the contributions of local experts, the most likely level of immunization coverage is determined for each country–year–antigen combination.  An essential part of this review is consultation and collaboration with national authorities, who are asked to review the draft estimates and provide comments.

  1. Burton, A., et al., ’A Formal Representation of the WHO and UNICEF Estimates of National Immunization Coverage: A computational logic approach’, PLOS ONE, vol. 7, no. 10:e47806, 2012.
  2. Kowalski R., A. Burton, ’WUENIC – A Case Study in Rule-based Knowledge Representation and Reasoning’, Lecture Notes in Computer Science, vol. 7258, 2012, pp. 112─125.
  3. Burton, A., et al., WHO and UNICEF Estimates of National Infant Immunization Coverage: Methods and processes, Bulletin of the World Health Organization, vol. 87, 2009, pp. 535─541.
  4. Brown DW, Burton AH, Gacic-Dobo M, Karimov RI. An Introduction to the Grade of Confidence Used to Characterize Uncertainty Around the WHO and UNICEF Estimates of National Immunization Coverage. Open Public Hlth J. 2013;6:73-76.
  5. Administrative data are collected through the WHO/UNICEF Joint Reporting Form on Vaccine-Preventable Diseases, completed annually by countries.

ImmunizationInfo: Expanding access to national immunization coverage estimates

The data above can also be viewed through ImmunizationInfo, an interactive online dissemination tool of national childhood immunization coverage statistics developed in 2010 by UNICEF and WHO in collaboration with Community Systems Foundation.  ImmunizationInfo is powered by DevInfo database technology and built using Adobe-Flex technology and allows users to view national immunization coverage estimates in graph, map and table formats based on a user-defined selection of country-year-vaccine combinations. Users can generate comparative graphs and also download the underlying data.