TABLE 1. Numbers and global percentages of surviving infants who did not receive the first dose of diphtheria-tetanus-pertussis–containing vaccine (zero-dose children),* by World Health Organization Region, World Bank economic classification, and Gavi, the Vaccine Alliance eligibility — worldwide, 2019, 2021, and 2022.
| Year/Characteristic | Global | WHO Region† |
Income classification§ |
Among Gavi-eligible countries¶ | ||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| AFR | AMR | EMR | EUR | SEAR | WPR | Low | Lower-middle | Upper-middle | High | |||
|
2019
| ||||||||||||
| No. of countries |
194
|
47 |
35 |
21 |
53 |
11 |
27 |
26 |
54 |
52 |
59 |
57 |
| No. of surviving infants (millions) |
134.3
|
37.0 |
14.0 |
18.1 |
10.5 |
33.3 |
21.4 |
23.0 |
64.6 |
35.0 |
12.0 |
74.3 |
| Global % of surviving infants |
—
|
27.5 |
10.4 |
13.5 |
7.8 |
24.8 |
15.9 |
17.1 |
48.1 |
26.0 |
9.0 |
55.3 |
| No. of zero-dose children (millions) |
12.9
|
6.2 |
1.5 |
1.9 |
0.3 |
2.0 |
1.1 |
3.9 |
6.8 |
2.2 |
0.3 |
9.0 |
| Global % of zero-dose children |
—
|
48.2 |
11.7 |
14.6 |
2.0 |
15.2 |
8.3 |
29.8 |
52.5 |
16.7 |
2.3 |
69.4 |
|
2021
| ||||||||||||
| No. of countries |
194
|
47 |
35 |
21 |
53 |
11 |
27 |
26 |
54 |
52 |
59 |
57 |
| No. of surviving infants (millions) |
130.5
|
38.1 |
13.6 |
18.2 |
10.2 |
32.8 |
17.6 |
24.0 |
64.5 |
30.7 |
11.8 |
75.2 |
| Global % of surviving infants |
—
|
29.2 |
10.4 |
14.0 |
7.8 |
25.1 |
13.5 |
18.4 |
49.4 |
23.5 |
9.1 |
57.7 |
| No. of zero-dose children (millions) |
18.1
|
7.6 |
1.8 |
2.1 |
0.3 |
4.6 |
1.6 |
4.9 |
9.9 |
3.1 |
0.3 |
12.4 |
| Global % of zero-dose children |
—
|
42.1 |
10.2 |
11.5 |
1.8 |
25.6 |
8.7 |
27.2 |
54.4 |
17.2 |
1.7 |
68.3 |
|
2022
| ||||||||||||
| No. of countries |
194
|
47 |
35 |
21 |
53 |
11 |
27 |
26 |
54 |
52 |
59 |
57 |
| No. of surviving infants (millions) |
130.6
|
38.6 |
13.6 |
18.2 |
10.1 |
32.7 |
17.4 |
23.3 |
64.5 |
30.4 |
11.8 |
75.7 |
| Global % of surviving infants |
—
|
29.5 |
10.4 |
14.0 |
7.7 |
25.0 |
13.4 |
17.8 |
49.4 |
23.3 |
9.0 |
58.0 |
| No. of zero-dose children (millions) |
14.3
|
7.8 |
1.3 |
1.7 |
0.3 |
2.1 |
1.1 |
4.7 |
7.3 |
1.9 |
0.3 |
10.2 |
| Global % of zero-dose children | — | 54.3 | 9.1 | 12.0 | 2.2 | 15.0 | 7.5 | 33.1 | 50.8 | 13.4 | 1.9 | 71.4 |
Abbreviations: AFR = African Region; AMR = Region of the Americas; DTPcv = diphtheria-tetanus-pertussis–containing vaccine; DTPcv1 = first dose of DTPcv; EMR = Eastern Mediterranean Region; EUR = European Region; GNI = gross national income; SEAR = South-East Asia Region; USD = U.S. dollars; WHO = World Health Organization; WPR = Western Pacific Region.
* Zero-dose children are surviving children who lack documentation of receipt of a dose of DTPcv1 by age 12 months. The 2022 WHO and UNICEF estimates of national immunization coverage used the 2022 World Population Prospect from the United Nations Population Division for estimates of national immunization coverage and for calculations of regional and global vaccination coverage figures. Estimates of live births and surviving infants in the 2022 World Population Prospect changed from previous years.
† Included countries are WHO countries.
§ Economic classification is based on 2022 GNI per capita, calculated using the World Bank Atlas method in USD (https://datahelpdesk.worldbank.org/knowledgebase/articles/906519-world-bank-country-and-lending-groups). Categorization is based on the World Bank’s economic classification for 2022, in which low-income economies are defined as those with GNI in USD per capita of ≤$1,135; lower middle-income economies, GNI = $1,136–$4,465; upper middle-income, GNI = $4,466–$13,845; and high-income, GNI >$13,845. For all years shown, Cook Islands and Niue are excluded in this classification because of lack of available GNI estimates. For 2021 and 2022, data for Venezuela were also excluded as temporarily unclassified pending release of revised national accounts statistics.
¶ Gavi is a public-private global health partnership that aims to increase access to immunization in poor countries. Eligibility is defined as a country’s average 3-year GNI per capita in USD. As GNI increases, a country moves through Gavi’s different eligibility phases until reaching the transition phase in which GNI exceeds the eligibility threshold (https://www.gavi.org/types-support/sustainability/eligibility). Gavi operates on a 5-year strategic period. For Gavi 4.0 (2016–2020), the number of countries decreased to 68 with the same GNI per capita threshold. For Gavi 5.0 (2021–2025), the number of countries remained at 57 but average 3-year GNI per capita threshold was increased to ≤$1,630. For analysis, this report retrospectively looks back at the current 57 Gavi-funded countries to compare across years.