Immunization in Europe and Central Asia

In Europe and Central Asia, the progress made in reaching children with lifesaving vaccines is under threat. 

Currently, countries are still recovering from backsliding in childhood vaccination rates caused by the COVID-19 pandemic. Escalating economic uncertainty, political polarisation, and decreasing trust, risk undermining decades of work to strengthen public health systems and services. 

At the same time, donor investment in immunization is falling in some countries that still require critical support.

Ongoing governance reforms are affecting both the structure and financing of immunization programmes. Some countries, challenged by competing priorities at home, and inaccessibly priced vaccines on the global market, experienced several vaccine shortages, sometimes causing critical disruptions to services. These issues are particularly acute in middle-income countries, many of which self-procure vaccines and continue to face significant challenges in achieving financial sustainability of their immunization programmes. 

In addition, challenges often assumed to be resolved in the European region persist. Data gaps and weak immunization information systems limit the ability to track coverage and respond to outbreaks. Only a few countries have fully digitized immunization registries. Sustainable, long-term funding for community engagement and demand generation efforts remains inconsistent, making it difficult to maintain high coverage and build trust over time. 

Vaccine confidence in Europe and Central Asia remains comparatively low³. A 2022⁴ report highlights significant declines in vaccine confidence, particularly in Baltic countries. Evidence from UNICEF-supported behavioural research shows that parents who perceive vaccines as safe, trust their child’s doctor, and value health worker recommendations are more likely to vaccinate their children on time. These insights underline the urgent need to invest in social and behavioural strategies that build public trust and equip health workers with the support and skills to effectively promote vaccination. 

Building vaccine confidence is only one part of the solution. A coordinated effort across all levels of society is needed to ensure no child is left behind. Immunization is a shared responsibility of governments, legislators, health care providers, parents, caregivers, the pharmaceutical industry and other stakeholders. Everyone has a role to play in vaccinating and protecting all children. Conversely, successfully reaching populations offers profound benefits: enhanced health equity, reduced disease burden, and a stronger, more resilient public health infrastructure for all. 

UNICEF has a long history of bringing stakeholders together to safeguard and promote immunization, both globally and in the Europe and Central Asia Region. We work with partners to strengthen routine immunization systems and step in whenever necessary to bolster immunization. We are committed to ensuring fully sustainable, well-resourced and managed immunization systems that guarantee vaccinations for each and every child – with no exceptions.

Did you know? 

The total cost of 127,000 measles cases in Europe and Central Asia in 2024 was 178 million USD. Every measles case costs the system over 1,200 USD–1,400 USD — while it only costs 30 USD–40 USD to fully immunize a child and prevent the case entirely.²