More than 870,000 children in Ethiopia miss out on lifesaving measles, diphtheria and tetanus vaccines in 2018

New global estimates find dangerous stagnation of global vaccination rates, due to conflict, inequality and complacency

16 July 2019
Polio vaccination a response of a recent polio outbreak in the Horn of Africa.
©UNICEF Ethiopia/2013/Sewunet

NEW YORK/GENEVA/ADDIS ABABA, 15 July 2019 – 20 million children worldwide and 872,828 children in Ethiopia missed out on lifesaving vaccines such as measles, pertussis, diphtheria and tetanus in 2018, according to new data from WHO and UNICEF.

Globally, since 2010, vaccination coverage with three doses of diphtheria, tetanus and pertussis (DTP3) and one dose of the measles vaccine has stalled at around 86 percent. While high, this is not sufficient. 95 percent coverage is needed – globally, across countries, and communities - to protect against outbreaks of vaccine-preventable diseases.

“Vaccines are one of our most important tools for preventing outbreaks and keeping the world safe,” said Dr Tedros Adhanom Ghebreyesus, Director-General of the World Health Organization. “While most children today are being vaccinated, far too many are left behind. Unacceptably, it’s often those who are most at risk– the poorest, the most marginalized, those touched by conflict or forced from their homes - who are persistently missed.”

Most unvaccinated children live in the poorest countries, and are disproportionately in fragile or conflict-affected states. Almost half are in just 16 countries - Afghanistan, the Central African Republic, Chad, Democratic Republic of the Congo (DRC), Ethiopia, Haiti, Iraq, Mali, Niger, Nigeria, Pakistan, Somalia, South Sudan, Sudan, Syria and Yemen.

If these children do get sick, they are at risk of the severest health consequences, and least likely to access lifesaving treatment and care.

Measles outbreaks reveal entrenched gaps in coverage, often over many years.

Stark disparities in vaccine access persist across and within countries of all income levels. This has resulted in devastating measles outbreaks in many parts of the world – including countries that have high overall vaccination rates.

In 2018, almost 350,000 measles cases were reported globally, more than doubling from 2017.

“Measles is a real time indicator of where we have more work to do to fight preventable diseases,” said Henrietta Fore, UNICEF’s Executive Director. “Because measles is so contagious, an outbreak points to communities that are missing out on vaccines due to access, costs or, in some places, complacency. We have to exhaust every effort to immunize every child.” 


Ten countries with the highest reported incidence rate of measles cases(2018) Coverage with measles first dose (2010) Coverage with measles first dose (2018)
1. Ukraine  56 91
2. Democratic Republic of the Congo  74 80
3. Madagascar  66 62
4. Liberia  65 91
5. Somalia  46 46
6. Serbia  95 92
7. Georgia  94 98
8. Albania  99 96
9.Yemen  68 64
10. Romania  95 90


Ukraine leads a varied list of countries with the highest reported incidence rate of measles in 2018. While the country has now managed to vaccinate over 90 percent of its infants, coverage had been low for several years, leaving a large number of older children and adults at risk.

Several other countries with high incidence and high coverage have significant groups of people who have missed the measles vaccine in the past. This shows how low coverage over time or discrete communities of unvaccinated people can spark deadly outbreaks.

Together with partners like Gavi, the Vaccine Alliance, WHO and UNICEF are supporting countries to strengthen their immunization systems and outbreak response, including by vaccinating all children with routine immunization, conducting emergency campaigns, and training and equipping health workers as an essential part of quality primary healthcare.

About Ethiopia

According to WHO and UNICEF national immunization coverage estimate, Ethiopia is the fifth country in the world with large number of unimmunized children. In 2018, 872,828 children were not immunized for the third dose of pentavalent vaccine and 1,215,724 children were not immunized with first dose of measles vaccines.

Though vaccination coverages for the first and third dose of DTP containing vaccine (pentavalent) in Ethiopia has increased from 77 per cent in 2010 to 85 per cent in 2018, measles vaccination coverage has shown a negligible decrease, from 64 per cent in 2010 to 61 percent in 2018. And 467,586 children have never been vaccinated at all. 

According to the 2016 Ethiopia Demographic and Health Survey report, the three biggest and populous regions of Ethiopia (Amhara, Oromia and SNNPR) constitute 85.5 per cent of unimmunized children. Incidence of unimmunized children (for all basic vaccines that are given in the country), per 100 children, is highest in Afar (80%) followed by Somali (64%) and Oromia (60%).

In addition, with the recent internal population movements, which cause service interruption, the number of unimmunized children in the country is expected to increase.

Media Contacts

Zerihun Sewunet
Communication Specialist
UNICEF Ethiopia
Tel: +251911500010
Sabrina Sidhu
Tel: +1 917 4761537

About the data

Since 2000, WHO and UNICEF jointly produce national immunization coverage estimates for Member States on an annual basis. In addition to producing the immunization coverage estimates for 2018, the WHO and UNICEF estimation process revises the entire historical series of immunization data with the latest available information. The 2018 revision covers 39 years of coverage estimates, from 1980 to 2018. DTP3 coverage is used as an indicator to assess the proportion of children vaccinated and is calculated for children under one year of age. The estimated number of vaccinated children are calculated using population data provided by the 2019 World Population Prospects (WPP) from the UN.

About WHO

The World Health Organization provides global leadership in public health within the United Nations system. Founded in 1948, WHO works with 194 Member States, across six regions and from more than 150 offices, to promote health, keep the world safe and serve the vulnerable. Our goal for 2019-2023 is to ensure that a billion more people have universal health coverage, to protect a billion more people from health emergencies, and provide a further billion people with better health and wellbeing. Visit our website Follow WHO on FacebookTwitterYouTubeInstagram


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