Only Canada, San Marino, Ireland, Austria and Argentina had worse childhood vaccination coverage than New Zealand. Photo: CDC
Between 2010 and 2019, progress in increasing vaccinations stalled and even reversed in some countries, including in 21 of 36 high-income countries such as Canada, France, Germany, Italy, Japan, UK, and US.
Australia had the 6th highest number of unvaccinated children in 2023 among high-income countries.
New Zealand and Australia had the 6th and 7th lowest percentage of vaccine coverage, respectively in 2023 among high-income countries.
By 2030, only the high-income super region is projected to reach the World Health Organization's 2030 immunisation targets, unless drastic changes are made in the next five years.
Childhood vaccination rates have dropped in 21 out of 36 high-income countries, with New Zealand ranking among the lowest in terms of coverage, new research has found.
According to the major new analysis from the Global Burden of Disease Study Vaccine Coverage Collaborators, published in The Lancet on Wednesday
New Zealand had the sixth lowest rate of coverage in 2023, just behind Australia.
Only Canada, San Marino, Ireland, Austria and Argentina had worse childhood vaccination coverage.
Since the World Health Organisation established the Expanded Programme on Immunization (EPI) in 1974, more than 4 billion children had been vaccinated, preventing the deaths of an estimated 154 million children.
Initially focusing on six childhood vaccine-preventable diseases (tuberculosis, diphtheria, pertussis, tetanus, polio, and measles), the programme later expanded to include protection against Haemophilus influenzae type B, Hepatitis B, rubella, pneumococcal disease, rotavirus, and human papillomavirus.
However, the last two decades have also been marked by stagnating childhood vaccination rates and "wide variation" in coverage - a trend further exacerbated by the Covid-19 pandemic, the report noted.
"Between 2010 and 2019, coverage gains slowed and, in some areas of the world, reversed.
"For example, 21 of 36 high-income countries experienced declines in coverage for at least one of the original EPI-recommended vaccine-doses (excluding the tuberculosis vaccine, which is no longer included in routine immunisation schedules in some countries) - including a 12 percent decline in first dose measles vaccination in Argentina, and 8 percent and 6 percent declines in third dose diphtheria-tetanus-pertussis vaccination in Finland and Austria, respectively.
"Additionally, the proportion of children receiving the measles vaccine declined in 100 of 204 countries, with the largest decrease observed in Latin America and the Caribbean, where coverage fell from around 90 percent in 2010 to 87 percent in 2019, resulting in almost one million fewer children being vaccinated against measles in 2019."
Children left vulnerable
Lead author Dr Jonathan Mosser from the Institute for Health Metrics and Evaluation at the University of Washington said this left millions of "under and un-vaccinated" children vulnerable to preventable disease and death.
"Routine childhood vaccinations are among the most powerful and cost-effective public health interventions available, but persistent global inequalities, challenges from the COpandemic, and the growth of vaccine misinformation and hesitancy have all contributed to faltering immunisation progress," he said.
"These trends increase the risk of outbreaks of vaccine-preventable diseases, including measles, polio, and diphtheria, underscoring the critical need for targeted improvements to ensure that all children can benefit from lifesaving immunisations."
In 2023, more than half of the world's 15.7m unvaccinated children were living in just eight countries, with 53 percent in sub-Saharan Africa.
Vaccine-preventable disease outbreaks persisted, including polio in Pakistan, Afghanistan and Papua New Guinea, where less than half the population is immunised.
In 2024, there was a nearly tenfold increase in measles infections recorded in the European Union and the European Economic Area, while the ongoing measles outbreak in the United States reached over 1000 confirmed cases across 30 states by May 2025.
The authors stressed that global immunisation goals for 2030 would not be met without targeted strategies and "efforts to tackle vaccine misinformation and hesitancy".
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