Immunization coverage falters in Southeast Asia; zero-dose children a top concern
The World Health Organization (WHO) South-East Asia region has raised an important healthcare issue that could save lives, calling for sustained efforts to expand vaccine access while warning that millions remain unprotected despite decades of progress in immunization.
It said that over the past 50 years, vaccines have saved more than 154 million lives worldwide, including about 38 million in the region. Immunization has also contributed to a 22% decline in infant mortality.
Catharina Boehme, Officer-in-Charge, WHO South-East Asia said vaccines are among the most effective and affordable health investments, according to the agency, and added that their full impact depends on reaching all populations.
Coverage missing the mark
In 2024, more than 14 million infants globally received no vaccines, while nearly 20 million missed at least one essential dose. These figures point to ongoing challenges in access, particularly among vulnerable and underserved groups.
Boehme said maintaining high immunization coverage is critical, warning that uneven coverage can increase the risk of outbreaks. She cited the measles situation in Bangladesh, where the government, with partner support, is expanding a nationwide measles and rubella campaign targeting 18.03 million children aged six months to five years, including more than 182,000 children in Cox’s Bazar, according to the agency.
Reaching the “Zero-Dose” children
It has been found that about 1.9 million children in the region remain “zero-dose,” meaning they have not received any vaccines. Many live in remote or underserved areas, including informal urban settlements and border regions, and face barriers such as distance, cost, and lack of documentation.
The WHO said reaching these populations requires targeted, data-driven strategies, stronger last-mile delivery systems, and services tailored to community needs.
Boehme said equity remains central to immunization efforts, stressing that reaching underserved populations is a key measure of health system performance.
She also pointed to the importance of trust and community engagement, with health workers serving as the most reliable source of vaccine information and playing a central role in maintaining public confidence.
More diseases covered
The South-East Asia region, home to about a quarter of the global population, has made steady advances through sustained investment. More than 94% of children now receive three doses of DTP-containing vaccine, compared to just 5% during the early years of the Expanded Program on Immunization in the 1970s.
Immunization programs have expanded from covering six diseases to 13 antigens. These efforts have helped eliminate maternal and neonatal tetanus, maintain polio-free status since 2014, and advance measles and rubella elimination. Countries have also introduced newer vaccines, including inactivated poliovirus, human papillomavirus, pneumococcal conjugate, and rotavirus vaccines.
The region has become a major global vaccine production hub, supplying nearly half of the world’s vaccines.
Wider immunization sought
As countries face pressures from climate change, urbanization, migration, and financial constraints, immunization remains a foundation of resilient health systems. Vaccines help prevent disease, strengthen emergency preparedness, and reduce antimicrobial resistance by lowering infection rates and the need for antibiotics.
Looking ahead, Boehme called for expanding vaccination across all age groups, including adolescents, adults, and older people, to address shifting health needs.
She said vaccines save lives and added that ensuring universal access is both achievable and necessary for stronger and more resilient societies, according to the WHO.
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