Millions of children worldwide are at risk of lethal diseases because vaccine coverage has stalled or reversed amid persistent health inequalities and soaring levels of misinformation and hesitancy, the largest study of its kind has found.
Major progress in rolling out jabs to billions of children over the last five decades has prevented the deaths of 154 million children, according to an analysis published in the Lancet. However, since 2010, progress has stalled or reversed in many countries. Measles vaccination rates have fallen in 100 of 204 countries, while coverage for at least one dose against diphtheria, tetanus, whooping cough, measles, polio or tuberculosis has declined in 21 of 36 high-income countries – including France, Italy, Japan, the UK and the US.
The reversal, further exacerbated by the disruption caused by the Covid-19 pandemic, has left millions of children vulnerable to preventable diseases and death, the authors of the study led by the University of Washington in Seattle said. Senior study author Dr Jonathan Mosser said: 'Large numbers of children remain under- and un-vaccinated. These trends increase the risk of outbreaks of vaccine-preventable diseases, including measles, polio and diphtheria.'
Vaccine-preventable disease outbreaks pose a growing global risk. Increasing numbers of wild-type polio cases have been reported in Afghanistan and Pakistan, and there is a polio outbreak in Papua New Guinea. In 2024, there was a nearly tenfold increase in measles infections recorded in Europe. The measles outbreak in the US reached more than 1,000 confirmed cases in 30 states in May 2025.
The new analysis provides updated global, regional and national estimates of annual routine childhood vaccination coverage from 1980 to 2023 in 204 countries and territories. The past 50 years has seen huge progress, with a 75% drop in the number of unvaccinated zero-dose children worldwide from 58.8 million in 1980 to 14.7 million in 2019. However, this long-term progress masks recent challenges and substantial disparities.
Lead author Dr Emily Haeuser called for more concerted efforts to tackle vaccine misinformation and hesitancy. Helen Bedford, professor of children's health at University College London, said action was necessary to tackle increasing social inequity and misinformation about vaccine safety and necessity, as well as improving public confidence in vaccination programmes.
