ISLAMABAD: A mounting childhood immunisation crisis is unfolding in Pakistan, which recorded the highest number of zero-dose children in the WHO Eastern Mediterranean Region in 2025. According to WHO and UNICEF estimates, 651,000 infants received no routine vaccinations, while another 465,000 failed to complete basic immunisation.
The latest WHO/UNICEF Estimates of National Immunisation Coverage (WUENIC) place Pakistan at the top of the regional ranking for zero-dose children, ahead of Afghanistan with 503,000, Yemen with 424,000, Somalia with 231,000, Syria with 135,000, and Iraq with 123,000. Pakistan alone accounts for nearly one-fifth of the region’s 2.38 million zero-dose children. A zero-dose child is one who fails to receive even the first dose of the diphtheria, tetanus and pertussis (DTP1) vaccine, making the indicator one of the strongest measures of inequitable access to primary healthcare and routine immunisation services. The report also identifies Pakistan among only five countries worldwide, alongside Bangladesh, South Africa, Nigeria, and Japan, where the number of zero-dose children increased between 2024 and 2025, despite overall improvements globally and across the Eastern Mediterranean Region. WHO and UNICEF attribute the continued setbacks in many countries to the lasting effects of the COVID-19 pandemic, conflict and insecurity, declining external funding for immunisation programmes, weak health systems, and rapidly growing birth cohorts. Although no country-specific explanation is provided, Pakistan’s large birth cohort and persistent routine immunisation gaps have contributed to the rising number of unvaccinated children. Pakistan’s DTP1 coverage was estimated at 93 per cent, meaning around 651,000 infants remained completely unreached by routine immunisation.Coverage dropped to 86 per cent for the third DTP dose, leaving nearly 1.1 million children either unvaccinated or under-vaccinated. Around 465,000 children received the first dose but failed to complete the three-dose schedule, indicating substantial dropout from the national immunisation programme. The data also reveal significant gaps in protection against several other vaccine-preventable diseases. Only 30 per cent of newborns received the hepatitis B birth dose, meaning 70 per cent missed timely protection against hepatitis B infection.
Coverage for the Haemophilus influenzae type b (Hib3) vaccine reached 86 percent, leaving around 14 percent of children without protection against meningitis and severe pneumonia. Coverage for the third dose of hepatitis B vaccine (HepB3) also stood at 86 per cent, while pneumococcal conjugate vaccine (PCV3) coverage was 86 per cent, leaving about one in seven children unprotected against serious bacterial infections. Coverage for the rotavirus vaccine reached 89 per cent, meaning roughly 11 per cent of children missed protection against severe diarrhoeal disease. The first dose of injectable polio vaccine (IPV1) reached 87 per cent, while completion of the injectable polio schedule stood at only 82 per cent, leaving nearly one in every five children without full protection. Measles vaccination also remained below international targets. Coverage for the first measles-containing vaccine (MCV1) was 84 per cent, meaning approximately 16 per cent of children missed the first dose, while second-dose measles coverage (MCV2) was 83 per cent, leaving nearly one in six children without complete protection. Rubella vaccine coverage was also estimated at 84 per cent. BCG coverage against tuberculosis remained comparatively high at 96 per cent. Health experts consider DTP1 coverage a measure of access to health services, while DTP3 reflects the ability of immunisation programmes to retain children until completion of the primary vaccination schedule. The sizeable gap between the two indicators points to weaknesses in follow-up, outreach, caregiver awareness, and continuity of vaccination services. Across the Eastern Mediterranean Region, an estimated 2.38 million children remained zero-dose in 2025, down from 2.75 million a year earlier. Pakistan, however, moved in the opposite direction and now has the region’s largest population of completely unvaccinated children. Globally, WHO and UNICEF estimate that 13.5 million children remained zero-dose in 2025, 745,000 fewer than in 2024 but still 674,000 more than before the COVID-19 pandemic in 2019. Worldwide, 19.6 million children either missed routine vaccinations or failed to complete the recommended three-dose DTP schedule.
Published in The News, July 15th, 2026.
