Gavi, the Vaccine Alliance, says 9.5 million children in 57 supported countries received no routine vaccine in 2025, despite gains in global immunisation.
The figure, described as the number of “zero-dose” children, was contained in Gavi’s 2025 Annual Progress Report, which reviewed the alliance’s 2021-2025 strategic period.
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Gavi defines zero-dose children as infants who have not received the first dose of a diphtheria, tetanus and pertussis-containing vaccine by the end of their first year.
Number falls from 2021 peak
According to the report, the number of zero-dose children in 2025 was 600,000 lower than in 2024 and 25 per cent lower than the peak recorded in 2021 following disruptions to routine immunisation caused by the COVID-19 pandemic.
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However, the figure remained four per cent above the 2019 baseline, partly because of continued growth in the number of children being born.
Gavi said children living in fragile, conflict-affected and humanitarian settings remain among those most likely to be missed by immunisation programmes.
Nigeria remains one of the countries with the highest number of zero-dose children. UNICEF estimated that about 2.2 million Nigerian children had never received a routine vaccine in 2025, the highest number in Africa.
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Nigeria records gains in targeted areas
The report highlighted Nigeria, Ethiopia and Pakistan among countries where emerging data showed stronger immunisation coverage gains in sub-national areas that received greater Gavi focus and investment during the 2021-2025 period.
Gavi said the findings underscored the value of targeted, equity-focused investments in reaching communities that are being missed by routine immunisation.
The report also identified Nigeria among countries covered by Gavi’s Zero-Dose Learning Hubs, which examined what works and what does not in identifying and reaching zero-dose and under-immunised children.
The findings from Nigeria, Bangladesh, Mali and Uganda highlighted several issues, including gender-related barriers to immunisation.
73m children immunised in 2025
Despite the number of zero-dose children, Gavi said more than 73 million children were immunised through routine programmes with its support in 2025.
More than 351 million children were immunised during the 2021-2025 strategic period, “exceeding Gavi’s target of 300 million children.”
“By end 2025, Gavi-supported countries had immunised more than 1.3 billion unique children with Gavi support since 2000, exceeding our Investment Opportunity 2021-2025 commitment of more than 1.1 billion children immunised by 2025,” it noted.
Gavi said vaccination averted more than 2.2 million future deaths in 2025, bringing the total number of future deaths averted through its supported vaccination programmes to more than 7.8 million during the 2021-2025 period.
Generated economic benefits
The report said immunisation programmes generated more than $30 billion in economic benefits for Gavi-supported countries in 2025, the highest amount recorded in a single year.
The benefits were calculated from the costs of illness averted, including medical and associated costs, caretaker wages and productivity losses resulting from disability or death.
Gavi said the programmes generated more than $104 billion in economic benefits between 2021 and 2025 and more than $308 billion between 2000 and 2025.
Countries also contributed a record $301 million towards the co-financing of Gavi-supported vaccines in 2025, an 18 per cent increase from 2024.
About 80 per cent of the contribution came from domestic resources, while “approximately 20 per cent from low-interest loans from the World Bank.”
Gavi said countries had contributed a total of $2.2 billion towards vaccine co-financing since the policy was introduced in 2008.
More children
For its 2026 to 2030 strategic period, Gavi said it aims to protect another 500 million children through immunisation and avert between eight million and nine million future deaths.
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The Alliance also targets more than $100 billion in economic benefits during the period. Gavi said it would place greater emphasis on reaching zero-dose and under-immunised children while strengthening the sustainability of national immunisation programmes.
In her comments, Gavi Chief Executive Officer, Sania Nishtar, said the results showed that immunisation generates benefits beyond preventing disease. “However, when it comes to immunisation we know that the return on investment extends far beyond health to supporting sustainable, inclusive economic growth,” Ms Nishtar said.
WHO Director-General, Tedros Ghebreyesus, also said immunisation delivers massive gains in lives saved and diseases prevented, but also in terms of economic benefits.
“Countries understand that the cost of failing to vaccinate is far too great, while the benefits extend across families, communities, economies and future generations,” Mr Ghebreyesus was quoted to have said.
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