By Emma Johnson
While childhood immunization has made remarkable strides globally, millions of children still remain unvaccinated or under-vaccinated. Understanding why this gap persists is essential to safeguarding public health worldwide.
Where the gaps remain
In 2025, approximately 13.5 million children didn’t receive a single routine vaccine dose—the so-called “zero-dose” group. Meanwhile, 85% of infants worldwide completed the full three-dose series for diphtheria, tetanus, and pertussis, but that number has stalled and remains short of global targets. Vaccines like HPV, targeting human papillomavirus, have seen only about one-third of girls receiving a first dose in many places. Yellow fever coverage in at-risk countries sits well below the recommended threshold. These numbers reflect uneven progress and highlight the areas where urgent attention is needed.
Causes of the disparities
Several interlinked factors contribute to vaccination gaps:
- Conflict and instability: Wars, civil unrest, and displacement disrupt health infrastructure, making access to immunization services unpredictable or impossible for many communities.
- Economic inequality: Low-income countries often lack the resources to maintain steady vaccine supply, while even within wealthier nations, marginalized populations may face obstacles such as costs or transportation.
- Misinformation & vaccine hesitancy: Misleading information about vaccine safety spreads rapidly, eroding trust. Hesitancy remains a powerful barrier, even where vaccines are available.
- Health logistics & workforce gaps: Cold-chain failures, understaffed clinics, remote or underserved regions—logistical challenges can prevent vaccines from reaching their intended populations.
Strategies making a difference
Despite the obstacles, progress is being made through coordinated international effort and local innovation:
- Building local capacity: Community health workers are being trained to conduct outreach, maintain vaccination records, and help families understand vaccine benefits.
- Strengthening supply chains: Improved forecasting, better cold-storage solutions, and more resilient delivery systems are helping reduce vaccine wastage and delays.
- Targeted campaigns: Catch-up immunization initiatives directed at zero-dose or dropout children—those who start vaccines but don’t complete them—are key to closing immunity gaps.
- Global funding & partnerships: International agencies, NGOs, and governments are collaborating to ensure vaccine equity—especially funding going to conflict zones or underserved regions.
Why this matters for Atlanta and beyond
Here at home, immigration, global travel, and refugee resettlement mean that vaccination gaps abroad can have local implications. Diseases once under control can re-emerge when unvaccinated individuals travel or resettle. Supporting global vaccination isn’t just about altruism—it’s about protecting communities everywhere.
Closing the vaccination divide is a complex, long-term effort. But as health workers, governments, and communities continue to adapt and collaborate, getting every child access to life-saving vaccines moves from a goal to an achievable reality.