Expanding immunization coverage


  • By 2020, ensure routine immunization of children under one year of age reaches 90 per cent nationally and at least 80 per cent coverage in every district or equivalent administrative unit.
  • Extend the benefits of new and improved vaccines to countries in need and provide twice-annual vitamin A supplementation or food fortification where necessary.

The Challenge

When the Expanded Programme on Immunization (EPI) was launched in 1974, less than five per cent of the world's children were immunized during their first year of life against six killer diseases — polio, diphtheria, tuberculosis, pertussis (whooping cough), measles and tetanus.

© UNICEF/NYHQ2011-0572/Halawani
A nurse administers an immunization to a baby at a clinic in Ein Al Beidah, a remote village in northern West Bank.

Today, 83 percent of the world's children under one year of age have received these life-saving vaccinations. Increasing numbers of countries, including low-income countries, are adding new and under-used vaccines, like Hepatitis B, Haemophilus influenzae type b (Hib) and yellow fever vaccine to their routine infant immunization schedules.

However, one-fifth of the world’s children – about 22.4 million infants – are not immunized against these killer diseases. More than 70 percent of these children live in ten countries. An estimated 1.5 million children died in 2011 from vaccine-preventable diseases. The deadlines for eliminating maternal and neonatal tetanus and certification of global polio eradication by 2010 have not been met.

The Solution

Sustainability is the key for the next phase of the drive towards full immunization. UNICEF is a leading partner in the Global Alliance for Vaccines and Immunization (GAVI), a far-reaching public-private partnership dedicated to increasing children’s access to vaccines in poor countries. The Alliance works to strengthen and expand routine immunization services and support the introduction of new and under-used vaccines, including those that protect against hepatitis B and Hib disease. The ultimate objective: establish immunization programmes that will function smoothly year after year as part of solid primary health care systems.

UNICEF works with governments and other partners including the World Health Organization, the World Bank, The Bill and Melinda Gates Foundation, the vaccine industry, civil society groups, and research and technical health institutes to make full immunization a part of every child’s life. Priority is given to about 40 nations where routine immunization coverage is lowest, and to the districts within those countries where children are least protected. These priority nations range from Indonesia and Sudan to India and Afghanistan.

In these countries, UNICEF helps local health managers to improve the planning and supervision of immunization activities and ensure a regular supply of vaccines, supports training for health workers and works with local leaders and media to educate communities and promote immunization. Special efforts are made to continue routine immunization in regions with poor health infrastructure, inaccessibility or conflict.


  • More than 100 million infants are immunized each year, saving 2-3 million lives annually.
  • Global mortality attributed to measles declined by 71 percent from an estimated 542,000 deaths in 2000, to 158,000 in 2011.
  • The prevalence of polio has declined dramatically since 1988, from more than 350,000 cases to 223 confirmed polio cases in 2012. Only three countries remain endemic – Afghanistan, Nigeria and Pakistan – down from more than 125 countries in 1988.
  • Immunization coverage against HepB and HiB has been increasing since 1990 – 180 and 177 countries now include HepB and HiB respectively  into infant immunization schedules.

Source: UNICEF/WHO, November 2011



Routine Immunization - Recommendations

WHO recommends that all children must receive:

  • 1 dose of BCG
  • 3 doses of DTP
  • 3 doses of oral or inativated polio vaccine (OPV/IPV)
  • 3 doses of HepB
  • 2 dose of measles vaccine (MCV)


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