A new global study reveals India is home to nearly 10% of the world’s completely unvaccinated children, raising concerns for future outbreaks and health equity.
India ranks among the eight countries that together account for over half of the world's unvaccinated children as of 2023. A global study published in The Lancet by the Global Burden of Disease (GBD) 2023 Vaccine Coverage Collaborators found that 1.44 million children in India had received no doses of the essential diphtheria, tetanus, and pertussis (DTP) vaccine during their first year of life. In total, 15.7 million children globally were found to be zero-dose - that is, they had not received even a single routine vaccine.
According to The Economic Times, the research analysed data across 204 countries and territories and found that although global childhood vaccine coverage has improved since 1980, this progress has been uneven. Countries like India, Nigeria, and the Democratic Republic of Congo continue to see large numbers of children missing out on basic immunisation, highlighting long-standing health access challenges. In 1980, 53.5% of zero-dose children lived in just five countries, including India. Today, that concentration remains largely unchanged.
Lead author Dr. Jonathan Mosser of the Institute for Health Metrics and Evaluation (IHME), University of Washington, noted that while many regions have halved their zero-dose population over the past few decades, setbacks in the past ten years - especially since the COVID-19 pandemic - have reversed gains. "Despite the monumental efforts of the past 50 years, progress has been far from universal," said Dr. Mosser. "Large numbers of children remain under- and un-vaccinated."
The study pointed out that while global zero-dose figures dropped by 75% between 1980 and 2019, progress stalled after 2010 and declined further post-2020. In fact, between 2010 and 2019, measles vaccination rates fell in nearly half of the world’s countries, including 21 high-income nations. The report suggests that an increase in misinformation, pandemic-related health system disruption, and resource constraints have all played a role in hindering immunisation efforts.
India’s numbers are concerning given its long-standing commitment to universal immunisation programs. Though the country has made significant strides through initiatives like Mission Indradhanush, the concentration of unvaccinated children remains high in certain regions. The study underscores the need for focused interventions, particularly in underserved and remote communities, where access to immunisation services remains limited.
The data also shows that South Asia and sub-Saharan Africa continue to bear the greatest burden. Two-thirds of the world’s zero-dose children live in these two regions, with South Asia accounting for over 1.3 million. Of the 204 countries studied, only 18 have achieved the global target of halving the number of zero-dose children by 2030 compared to 2019 levels. The authors say the target is still possible, but only with accelerated and focused action.
Dr. Mosser added, “The trends increase the risk of outbreaks that can be prevented through vaccinations, including measles, polio, and diphtheria. The critical need now is for targeted improvements to ensure all children benefit from life-saving immunisations.”
The challenge ahead lies in adapting immunisation delivery to reach the last mile; through mobile clinics, digital tracking tools, community health workers, and behaviour-change strategies to address vaccine hesitancy. As India continues to grow its healthcare infrastructure and workforce, the urgency of reaching every child, regardless of geography or income, cannot be overstated. Without timely course correction, the consequences may be visible not just in health indicators, but also in the country’s broader development goals.
