A new report reveals the world is falling well short of the global targets set in the Immunization Agenda 2030 (IA2030) – the global immunization strategy which aims to ensure everyone, everywhere benefits from life-saving vaccinations.
The IA2030 Global progress report 2024 finds that nearly 4.2 million deaths were averted by vaccination against 14 diseases in 2023, falling short of the target of nearly 4.6 million deaths. More than 3 out of 4 deaths averted resulted from preventing measles, hepatitis B and pertussis infections. Countries aim to avert 50 million deaths from vaccine-preventable diseases between 2021 and 2030.
However, the report reveals more deaths could be averted if more low- and middle-income countries introduce new or under-utilized vaccines and increase coverage for vaccines against measles, human papillomavirus (HPV), meningitis A, hepatitis B and yellow fever. The analysis did not include the impact of vaccines against COVID-19 or malaria.
The report also finds millions of zero-dose children − those who have never received a single vaccine − remain beyond the reach of health systems and weak supply chains complicate delivery. In 2023, there were 14.5 million zero-dose children globally, 33% more than the 2023 target.
Overall, global vaccination coverage is stalling, with immunization programmes only reaching 84% of children globally with the third dose of vaccine protecting against diphtheria, tetanus, and pertussis (DTP3).
The report warns that global outbreaks of vaccine-preventable diseases are increasing, rather than decreasing as called for in IA2030. In 2023, there were 109 large or disruptive outbreaks of measles, circulating vaccine-derived poliovirus (cVDPV), cholera and meningococcal disease, an 43% increase over the 2021 baseline. Inadequate immunization coverage and delayed and low-coverage supplementary immunization campaigns have created substantial immunity gaps in populations where outbreaks can easily occur, such as in fragile, vulnerable and conflict-affected settings.
Yet the report finds the IA2030 targets are still attainable.
Encouraging signs include rising coverage of human papillomavirus (HPV) vaccine which has reached 20% globally, driven by recent rollouts in low- and middle-income countries. Further, pneumococcal conjugate vaccine third dose (PCV3) coverage has reached 83% in the 157 countries where the vaccine has been introduced, which is now comparable to global third dose of diphtheria, tetanus and pertussis vaccine (DTP3) coverage. This is driven by its roll-out in India and Indonesia with large populations. In the WHO African Region, HPV coverage increased by over 15% in the past year, and the Region of the Americas has now exceeded pre-pandemic DTP3 coverage levels, now at 55%.
Since 2021, there have been 258 introductions of new or under-utilized vaccines in low- and middle-income countries, exceeding the 2023 target by 108. Regionally, DTP3 coverage in the WHO African Region and the Region of the Americas increased, with coverage in the latter now significantly above the 2019 baseline.
However, the gains are uneven. Countries that have transitioned out of Gavi support saw small declines in some key vaccine indicators, including DTP3 coverage which was at 82% in 2022 to 76% in 2023, and measles-containing vaccine second dose (MCV2) coverage at 68% in 2022 to 66% in 2023. Meanwhile, middle-income countries that were never Gavi-eligible still lag in HPV and PCV3 coverage due to slower vaccine introductions.
The report emphasizes that achieving IA2030 goals will require dedicated and coordinated action between countries and international partners. Together, we need to keep expanding vaccine access across the life course, closing equity gaps both between and within countries, and strengthening routine immunization systems as part of integrated primary health care.
With targeted support and country-led commitment, the global community can still fulfil IA2030's vision: ensuring that everyone, everywhere, at every age, is protected through the full benefits of immunization.
