🕷️ Crawler Inspector

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Direct Parameter Lookup

Raw Queries and Responses

1. Shard Calculation

Query:

Response:

Calculated Shard: 144 (from laksa004)

2. Crawled Status Check

Query:

curl -X POST \
  'http://laksa144.int.ahrefs:8124/' \
  -H 'Content-Type: text/plain' \
  -H 'X-ClickHouse-Database: crawler3' \
  -H 'Authorization: Basic YXBpOg==' \
  -d 'SELECT getAhrefsURLFromUnparsed(src_unparsed) AS found_url, ifNull(toUnixTimestamp(download_stamp), 0) AS crawl_time, ifNull(toUnixTimestamp(props_url_first_seen), 0) AS first_indexed_time, download_http_code AS http_code, src_unparsed AS src_unparsed, src_root_hash AS src_root_hash, history_drop_reason AS history_drop_reason, meta_title AS meta_title, meta_descriptions AS meta_descriptions, attrs_boilerpipe_text AS attrs_boilerpipe_text, attrs_markdown AS attrs_markdown, attrs_readable_markdown AS attrs_readable_markdown, meta_canonical AS meta_canonical FROM crawler3.page_info_local FINAL PREWHERE (src_root_hash, src_unparsed) IN ((getAhrefsRootHashFromUnparsed(getAhrefsUnparsedNoserviceFromURL(\'https://www.unicef.org/eca/reports/focus-immunization-2024\')), getAhrefsUnparsedNoserviceFromURL(\'https://www.unicef.org/eca/reports/focus-immunization-2024\'))) FORMAT JSONEachRow'

Response:

{"found_url":"https:\/\/www.unicef.org\/eca\/reports\/focus-immunization-2024","crawl_time":1774344778,"first_indexed_time":1731555321,"http_code":200,"src_unparsed":"org,unicef!www,\/eca\/reports\/focus-immunization-2024 s443","src_root_hash":"8707813859145415744","history_drop_reason":null,"meta_title":"In Focus: Immunization | UNICEF Europe and Central Asia","meta_descriptions":["Promoting and strengthening a life-saving investment"],"attrs_boilerpipe_text":"Flagship report\nPromoting and strengthening a life-saving investment\nUNICEF\/UN0635915\/Babajanyan VII Photo\nHighlights\nImmunization is one of the world’s most cost-effective public health interventions, preventing an estimated 4.4 million deaths each year, and protecting millions of children from preventable illness and disability.\nYet, global childhood immunization coverage stalled in 2023, and the number of children worldwide who are under-vaccinated or not vaccinated at all has increased by 2.7 million since 2019, before the COVID-19 pandemic.  \nIn Europe and Central Asia, coverage of the first dose of the diphtheria-tetanus-pertussis (DTP1) vaccine in 2023 had recovered to its pre-pandemic level (2019) of 97 per cent. Coverage of the third dose (DTP3) – seen as the benchmark for the strength of routine immunization services – has also reached its pre-pandemic level, rising from 93 per cent in 2021 to 95 per cent.\nYet 400,000 fewer children were vaccinated with DTP1 in the region in 2023 than in 2019, and 123,000 children remain completely unvaccinated. These ‘zero dose’ children remain vulnerable to, and unprotected from, measles, diphtheria and other life-threatening – but entirely preventable – diseases. There are also serious concerns about a surge in measles cases.\nA global strategy is in place – Immunization Agenda 2030 – to make vaccination available to everyone, everywhere, by the end of this decade. The challenge ahead is to fully reinvigorate immunization systems in the aftermath of the pandemic. This means closing the remaining coverage gaps within countries; ensuring effective immunization for the unprecedented numbers of children on the move across the region; and tackling the persistent ‘vaccine hesitancy’ that is fuelled by misinformation.\nUNICEF knows that every child benefits when all countries achieve and maintain high vaccine coverage across their entire territory. We work with governments, international agencies, non-governmental organizations and vaccine manufacturers to strengthen health systems and ensure supplies of life-saving vaccines for all children. We also aim to increase demand for immunization, educating the public on its importance, and equipping parents and communities with the knowledge they need to protect their children.\nPublication date\nNovember 2024\nLanguages\nEnglish\nKey policy frameworks\nConvention on the Rights of the Child (1989)\nArticle 24: States Parties recognize the right of the child to the enjoyment of the highest attainable standard of health and to facilities for the treatment of illness and rehabilitation of health. States Parties shall strive to ensure that no child is deprived of his or her right of access to such health care services.\nImmunization Agenda 2030 (2020)\nThis global strategy, endorsed by the World Health Assembly in 2020, aims for a world where everyone, everywhere, at every age, fully benefits from vaccines for good health and well-being.\nChallenges\nUNICEF has raised the alarm over a\nsurge in measles cases\n, attributed to major backsliding in childhood immunization coverage. More than 1.8 million children in Europe and Central Asia have missed their measles vaccination over the past three years. The region now accounts for around half of the measles cases worldwide. There were more than 61,070 confirmed cases in the Europe and Central Asia region in 2023, up from just over 900 in 2022. And by September 2024, the European region had registered around 95,204 cases of measles, highlighting the insufficient response of the system to prevent the spread. Immunization coverage is crucial to control this crisis and safeguard the health of millions of children across the region. It is vital to address this urgent challenge, and improved immunization coverage is crucial to safeguard the health of millions of children across the region.\nThe\nwar in Ukraine\nis having a devastating impact on the health and well-being of its population. Mass displacement presents public health challenges both within Ukraine and in refugee-hosting communities and increases the risk of outbreaks of vaccine-preventable disease. Efforts to maintain Europe’s ‘polio free’ status, for example, now need to accelerate and intensify, backed by action to reinforce health systems in general, and immunization in particular.\nImmunization\ninequity continues\nto hamper efforts to reach the most vulnerable children with life-saving vaccines. Roma populations across the region, for example, have lower immunization coverage than non-Roma populations. According to findings from the UNICEF Multiple Indicator Cluster Surveys (MICS) conducted in Roma settlements, stark disparities between Roma and non-Roma communities reflect major challenges in accessing essential services, including basic healthcare and immunization. In Serbia, only 70 per cent of Roma children aged 18-29 months are fully immunized, compared to 89 per cent of non-Roma children. This inequity is also seen in Kosovo\n1\n, where only 42 per cent of Roma children aged 12-23 months have received all the basic antigens, in contrast to 90 per cent of non-Roma children. \nSuch alarming discrepancies emphasize the\nurgent need for targeted interventions\nto address the substantial gaps in immunization access between different communities. They also reveal a diverse picture within countries across the region, with immunization coverage rates falling below 80 per cent in certain districts, far below safe levels. These gaps and disparities must be addressed to protect children against preventable but deadly diseases – a task that requires constant vigilance. \nThe\ncapacity of immunization programmes\nneeds to expand in response to the emergence of new vaccines, which – while welcome – are adding to the complexity of immunization programming. These new vaccines are vital to provide an effective barrier to the transmission of vaccine-preventable diseases, such as pneumococcal disease and rotavirus, and to protect against cervical and other forms of cancers through, for example, vaccination against human papillomavirus. However, they entail a shift from the vaccination of infants alone to vaccinations across the course of life, including infancy, childhood and adolescence, and this is stretching the capacities of immunization programmes in many places. \nIn addition, many countries in the region are classified as ‘middle-income’ and this has implications for their eligibility for official development assistance. There are\nconcerns about the financial sustainability\nof their national immunization programmes, as increased national income does not guarantee that there is enough capacity for effective management. \nThere are also concerns about\n‘vaccine hesitancy’ \n– a growing mistrust or even refusal of immunization among some parents, fueled by myths and misinformation. Parents’ refusal to immunize their children may stem from negative media stories that falsely link child deaths or disabilities to vaccination. It may also be influenced by unfounded fears around vaccine safety spread by anti-vaccine movements, and exacerbated by a lack of clear and consistent information for parents about the importance of immunization and its minimal risks.\n1 All references to Kosovo should be understood to be in the context of United Nations Security Council resolution 1244 (1999)\nUNICEF’s work for children\nUNICEF works with governments across Europe and Central Asia to\ninvest in health systems\nthat reach the most vulnerable children with life-saving immunizations, aiming to ensure that immunization is both universal and equitable. We know how to get the right vaccines to the right children at the right time, working with our partners to deploy new techniques and strategies to reach children in need and improve health systems. \nWe support\nthe provision of quality-assured vaccines\n, working with national governments, the World Health Organization, Gavi – the Vaccine Alliance, the Bill & Melinda Gates Foundation, the US and European Centers for Disease Control, and the Measles & Rubella Initiative (MRI), as well as non-governmental organizations, vaccine manufacturers and many others. We also mobilize funds and provide technical support to strengthen the development of evidence-based policies and increase the capacities of national immunization programmes, including budgeting for vaccine procurement and supply. \nUNICEF supports countries to\nintroduce new vaccines\n, such as those for rotavirus, and the pneumococcal conjugate vaccine (PCV) and human papillomavirus vaccine (HPV) to protect children from a wider range of preventable diseases. We also help to strengthen the capacity of national and sub-national partners\nto create demand for immunization\n, aiming to address vaccine hesitancy, build public trust, tackle dangerous myths and combat misinformation. \nOur efforts include technical support for governments and partners on\nsocial-science research\nto gather data and other evidence. This is essential to build a greater understanding of the factors that influence vaccine hesitancy to inform communication strategies, capacity building plans for front-line health workers and community engagement. For example, we work closely with national and local authorities to reinforce the routine tracking of public perceptions and attitudes around immunization to address issues related to vaccine hesitancy and the spread of misinformation by anti-vaccine campaigners. \nProtecting children from polio during war\nAs the war in Ukraine continues, and people continue to flee from their homes, gaps in immunization coverage put children’s health at risk. UNICEF is working with its partners to keep vaccination going and maintain high routine coverage across the country, including the provision of catch-up vaccination for those children who have missed their scheduled vaccines.\nTo go the last mile in polio eradication, UNICEF implements programmes that go beyond the traditional ‘two drops’ of polio vaccine, aiming to strengthen health systems and understand the behavioural and social drivers that shape public health. Not only are these crucial and life-saving investments, they are also vital for shared global health security.\n“Infectious diseases do not disappear during war,” says Yuliia Dovjanych, Head Doctor at the ‘Dbayu’ medical centre. “We must continue to get vaccinated, take care of our health and the health of our children.”\nIn 2022, UNICEF procured more than 2 million doses of vaccines for Ukraine. In 2023, more than 650,000 doses of the polio vaccine and 657,000 doses of the combined measles-mumps-rubella vaccine were delivered, as well as almost 6.2 million syringes.\nUNICEF has also strengthened the cold chain, which ensures that vaccines are transported and stored at the right temperature, at all levels.\nThrough the COVAX initiative, UNICEF purchased 26 freezers to be installed at national and regional levels to strengthen the immunization chain.\nAlmost 5,200 vaccine refrigerators and freezers procured with World Bank funds will support safe vaccine storage at vaccination points.\nUNICEF and USAID have also procured 36 refrigerator vans to transport vaccines from national centres to local (oblast) level and from there to vaccination points.\nVaccine carriers and cold boxes for vaccine storage and transportation have been provided for over 2,500 vaccination points and 800 mobile teams have been operating across Ukraine.\nEven in the most complex conflict settings, UNICEF and its partners know how to prevent catastrophic disease outbreak and are determined to make polio history.\nUzbekistan: HPV vaccination across generations\nNargiza received her first HPV vaccine shot at her school in Tashkent city, Uzbekistan, when she was 16. A doctor visited her school to tell the students that the vaccine would protect them from cancers and assured them of its safety.\n“I remember there were rumours that your fertility could be impacted, but I understood that the purpose of vaccines is to prevent disease,” Nargiza said.\n“I had no doubts about receiving the shot.”\nNargiza put her faith in scientific facts. After receiving her dose she had a mild headache – \na common side effect and a small sacrifice for her peace of mind.\nNow aged 26 and still living in Tashkent, Nargiza is protecting her whole family against preventable illness through vaccines given to her children at the prescribed ages. While her daughters aged 2 and 4 aren’t old enough to have the HPV vaccine, they have had all their other vaccinations at the right time.\nNargiza is creating a lasting tradition of vaccination in her family. She advocates that vaccines protect against preventable illnesses such as COVID-19, and against the human papillomavirus (HPV). While misinformation still abounds about vaccines and their side effects, she knows they exist only to protect people’s health and well-being.\nYet the phenomenon known as ‘vaccine hesitancy’ persists. This fear of vaccines is founded on misinformation and dangerous myths, and UNICEF and its partners are fully committed to overcoming it. UNICEF is working with the World Health Organization and the Uzbekistan Ministry of Health to raise public awareness of vaccine-preventable diseases by, for example, sharing a range of information materials to help healthcare providers communicate with parents and caregivers and answer their frequently asked questions.\nTV shows, radio programmes and public service announcements on national and regional channels encourage parents to trust immunization services and protect children from preventable diseases.\n“Vaccines train our bodies  – train our immune systems – to be ready to fight illness. This is what I tell people who don’t want to get vaccinated. All people should vaccinate their children and themselves. It’s our best protection.”\nCall to action\nLow vaccination rates and ongoing measles outbreaks in the region call for vigilance and greater efforts to improve universal routine immunization to protect children. Immunization strategies need to be tailored to reach all ‘zero dose’ and under-vaccinated children, including those in marginalized communities where the services are inadequate; those who may have become disconnected from services or are unreached by them; and those affected by conflict and insecurity.\nUNICEF is urging countries across the region to:\nurgently identify and reach all children with immunization, especially those who have missed vaccinations\nstrengthen demand for vaccines, including by building confidence\nprioritize funding to immunization services and primary health care\nbuild resilient health systems through investment in health workers, innovation and local manufacturing to ensure robust local action that reaches everyone, everywhere with vaccines.\nOne of UNICEF’s primary goals is to create an enabling environment for immunization and primary health care by 2030. This involves developing supportive policies, strengthening health systems, and fostering community engagement to lay a strong foundation for effective health services. Another critical objective is to enhance equitable access to quality immunization services. UNICEF aims to ensure that all individuals, particularly those who are the most vulnerable, can benefit from high-quality immunization services provided through resilient and well-supported primary health care systems.\nImmunization 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. \nUNICEF has a long history of bringing stakeholders together to safeguard and promote immunization, both globally and in the Europe and Central Asia Region. We will continue to work with partners to strengthen routine immunization systems and step in whenever necessary to bolster immunization. The task ahead is to ensure fully sustainable, well-resourced and managed immunization systems that guarantee vaccinations for each and every child – with no exceptions.","attrs_markdown":"[Skip to main content](https:\/\/www.unicef.org\/eca\/reports\/focus-immunization-2024#main-content)\n\n- [Ukraine response](https:\/\/www.unicef.org\/ukraine\/en)\n\nUNICEF supports children and families in emergencies\n\n[Click to close the emergency alert banner.](https:\/\/www.unicef.org\/)\n\n[![Europe and Central Asia](https:\/\/www.unicef.org\/eca\/sites\/unicef.org.eca\/files\/styles\/logo\/public\/English_21.png.webp?itok=w31XkOq5)](https:\/\/www.unicef.org\/eca\/ \"UNICEF\")  Europe and Central Asia\n\nToggle navigation\n\nCurrent language: English\n\nClick to select different language\n\n- [Current language: English](https:\/\/www.unicef.org\/eca\/reports\/focus-immunization-2024)\n- [русский](https:\/\/www.unicef.org\/eca\/reports\/focus-immunization-2024)\n\n- [Visit UNICEF Global](https:\/\/www.unicef.org\/)\n\n[![Europe and Central Asia](https:\/\/www.unicef.org\/eca\/sites\/unicef.org.eca\/files\/styles\/logo\/public\/English_21.png.webp?itok=w31XkOq5)](https:\/\/www.unicef.org\/eca\/ \"UNICEF\")  Europe and Central Asia\n\n[Press centre](https:\/\/www.unicef.org\/eca\/press-centre)\n\n[Donate](https:\/\/help.unicef.org\/)\n\n[![Europe and Central Asia](https:\/\/www.unicef.org\/eca\/sites\/unicef.org.eca\/files\/styles\/inverse_logo\/public\/English-Inverse_11.png.webp?itok=UOLthQ59)](https:\/\/www.unicef.org\/eca\/ \"UNICEF\")  Europe and Central Asia\n\n- [About us](https:\/\/www.unicef.org\/eca\/about-us)\n  - 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Donate\n    [Donate]()\n    - [Become a Donor](https:\/\/donate.unicef.org\/donate\/now)\n  - Connect\n    [Connect]()\n    - [Contact us](https:\/\/www.unicef.org\/eca\/take-action)\n    - [Work with us](https:\/\/jobs.unicef.org\/en-us\/filter\/?search-keyword=&location=switzerland)\n  - Communities\n    [Communities]()\n    - [Bebbo: the parenting app](https:\/\/www.unicef.org\/eca\/Bebbo-parenting-app)\n    - [Enter the chat](https:\/\/www.unicef.org\/eca\/enter-chat)\n    - [Let's get learning](https:\/\/www.unicef.org\/eca\/no-child-left-behind-letsgetlearning)\n\nSearch area has closed.\n\nSearch area has opened.\n\nSearchClose\n\nSearch form\n\nFlagship report\n\n# In Focus: Immunization\nPromoting and strengthening a life-saving investment\n\n![Six-year old Muso Ahliddinzoda smiles as he looks down at his arm, held by his father, after the boy has his routine vaccinations at a health centre in Dushanbe, Tajikistan. March 2022.](https:\/\/www.unicef.org\/eca\/sites\/unicef.org.eca\/files\/styles\/hero_extended\/public\/UN0635915%20%281%29.webp?itok=YRiZ0eO2)\n\n![Six-year old Muso Ahliddinzoda smiles as he looks down at his arm, held by his father, after the boy has his routine vaccinations at a health centre in Dushanbe, Tajikistan. March 2022.](https:\/\/www.unicef.org\/eca\/sites\/unicef.org.eca\/files\/styles\/lazy_load\/public\/UN0635915%20%281%29.webp?itok=fKD7kj6H)\n\nUNICEF\/UN0635915\/Babajanyan VII Photo\n\n### Highlights\n### Immunization is one of the world’s most cost-effective public health interventions, preventing an estimated 4.4 million deaths each year, and protecting millions of children from preventable illness and disability.\nYet, global childhood immunization coverage stalled in 2023, and the number of children worldwide who are under-vaccinated or not vaccinated at all has increased by 2.7 million since 2019, before the COVID-19 pandemic.\n\nIn Europe and Central Asia, coverage of the first dose of the diphtheria-tetanus-pertussis (DTP1) vaccine in 2023 had recovered to its pre-pandemic level (2019) of 97 per cent. Coverage of the third dose (DTP3) – seen as the benchmark for the strength of routine immunization services – has also reached its pre-pandemic level, rising from 93 per cent in 2021 to 95 per cent.\n\nYet 400,000 fewer children were vaccinated with DTP1 in the region in 2023 than in 2019, and 123,000 children remain completely unvaccinated. These ‘zero dose’ children remain vulnerable to, and unprotected from, measles, diphtheria and other life-threatening – but entirely preventable – diseases. There are also serious concerns about a surge in measles cases.\n\nA global strategy is in place – Immunization Agenda 2030 – to make vaccination available to everyone, everywhere, by the end of this decade. The challenge ahead is to fully reinvigorate immunization systems in the aftermath of the pandemic. This means closing the remaining coverage gaps within countries; ensuring effective immunization for the unprecedented numbers of children on the move across the region; and tackling the persistent ‘vaccine hesitancy’ that is fuelled by misinformation.\n\nUNICEF knows that every child benefits when all countries achieve and maintain high vaccine coverage across their entire territory. We work with governments, international agencies, non-governmental organizations and vaccine manufacturers to strengthen health systems and ensure supplies of life-saving vaccines for all children. We also aim to increase demand for immunization, educating the public on its importance, and equipping parents and communities with the knowledge they need to protect their children.\n\nPublication date\n\nNovember 2024\n\nLanguages\n\nEnglish\n\n### Files available for download\n[Report (pdf, 1 MB)](https:\/\/www.unicef.org\/eca\/media\/37556\/file\/In%20Focus%20Immunization.pdf)\n\n## Key facts\n![In Focus Immunization](https:\/\/www.unicef.org\/eca\/sites\/unicef.org.eca\/files\/styles\/mc_three_hrz_desktop\/public\/47.webp?itok=H1XIyTG_)\n\n![In Focus Immunization](https:\/\/www.unicef.org\/eca\/sites\/unicef.org.eca\/files\/styles\/mc_three_hrz_desktop\/public\/47.webp?itok=H1XIyTG_)\n\n![In](https:\/\/www.unicef.org\/eca\/sites\/unicef.org.eca\/files\/styles\/lazy_load\/public\/47.webp?itok=5MYE0_Wp)\n\n![In Focus Immunization](https:\/\/www.unicef.org\/eca\/sites\/unicef.org.eca\/files\/styles\/mc_three_hrz_desktop\/public\/48.webp?itok=hJwjmEbe)\n\n![In Focus Immunization](https:\/\/www.unicef.org\/eca\/sites\/unicef.org.eca\/files\/styles\/mc_three_hrz_desktop\/public\/48.webp?itok=hJwjmEbe)\n\n![In](https:\/\/www.unicef.org\/eca\/sites\/unicef.org.eca\/files\/styles\/lazy_load\/public\/48.webp?itok=riU4JWIv)\n\n![In Focus Immunization](https:\/\/www.unicef.org\/eca\/sites\/unicef.org.eca\/files\/styles\/mc_three_hrz_desktop\/public\/49.webp?itok=reUZ6MYd)\n\n![In Focus Immunization](https:\/\/www.unicef.org\/eca\/sites\/unicef.org.eca\/files\/styles\/mc_three_hrz_desktop\/public\/49.webp?itok=reUZ6MYd)\n\n![In](https:\/\/www.unicef.org\/eca\/sites\/unicef.org.eca\/files\/styles\/lazy_load\/public\/49.webp?itok=bgw_8Q1a)\n\n![In Focus Immunization](https:\/\/www.unicef.org\/eca\/sites\/unicef.org.eca\/files\/styles\/mc_three_hrz_desktop\/public\/50.webp?itok=ZhDdhrjM)\n\n![In Focus Immunization](https:\/\/www.unicef.org\/eca\/sites\/unicef.org.eca\/files\/styles\/mc_three_hrz_desktop\/public\/50.webp?itok=ZhDdhrjM)\n\n![In](https:\/\/www.unicef.org\/eca\/sites\/unicef.org.eca\/files\/styles\/lazy_load\/public\/50.webp?itok=hc1-tXI5)\n\n![In Focus Immunization](https:\/\/www.unicef.org\/eca\/sites\/unicef.org.eca\/files\/styles\/mc_three_hrz_desktop\/public\/51.webp?itok=6E8a_Cd1)\n\n![In Focus Immunization](https:\/\/www.unicef.org\/eca\/sites\/unicef.org.eca\/files\/styles\/mc_three_hrz_desktop\/public\/51.webp?itok=6E8a_Cd1)\n\n![In](https:\/\/www.unicef.org\/eca\/sites\/unicef.org.eca\/files\/styles\/lazy_load\/public\/51.webp?itok=Yc-olfzv)\n\n![In Focus Immunization](https:\/\/www.unicef.org\/eca\/sites\/unicef.org.eca\/files\/styles\/mc_three_hrz_desktop\/public\/52.webp?itok=Fy6RdcJ_)\n\n![In Focus Immunization](https:\/\/www.unicef.org\/eca\/sites\/unicef.org.eca\/files\/styles\/mc_three_hrz_desktop\/public\/52.webp?itok=Fy6RdcJ_)\n\n![In](https:\/\/www.unicef.org\/eca\/sites\/unicef.org.eca\/files\/styles\/lazy_load\/public\/52.webp?itok=lgCXooFt)\n\nCollection row media\n\n![In Focus Immunization](https:\/\/www.unicef.org\/eca\/sites\/unicef.org.eca\/files\/styles\/mc_one_hrz_desktop\/public\/In%20focus%20Immunization_0.webp?itok=2uv39bX5)\n\n![In Focus Immunization](https:\/\/www.unicef.org\/eca\/sites\/unicef.org.eca\/files\/styles\/mc_one_hrz_desktop\/public\/In%20focus%20Immunization_0.webp?itok=2uv39bX5)\n\n![In](https:\/\/www.unicef.org\/eca\/sites\/unicef.org.eca\/files\/styles\/lazy_load\/public\/In%20focus%20Immunization_0.webp?itok=-xhkv0fk)\n\n![Six-month-old Bilal is kissed on the cheek by his brother, Nurtilek, 17, after receiving his routine immunizations during a visit to a Family Medicine Centre in Bishkek, Kyrgyzstan. November 2022.](https:\/\/www.unicef.org\/eca\/sites\/unicef.org.eca\/files\/styles\/media_large_image\/public\/UN0760586.webp?itok=U1nzVzWl)\n\n![Six-month-old Bilal is kissed on the cheek by his brother, Nurtilek, 17, after receiving his routine immunizations during a visit to a Family Medicine Centre in Bishkek, Kyrgyzstan. November 2022.](https:\/\/www.unicef.org\/eca\/sites\/unicef.org.eca\/files\/styles\/lazy_load\/public\/UN0760586.webp?itok=CMy_NCPY)\n\nUNICEF\/UN0760586\/Babajanyan VII Photo  Six-month-old Bilal is kissed on the cheek by his brother, Nurtilek, 17, after receiving his routine immunizations during a visit to a Family Medicine Centre in Bishkek, Kyrgyzstan. November 2022.\n\n## Key policy frameworks\n![In Focus Immunization](https:\/\/www.unicef.org\/eca\/sites\/unicef.org.eca\/files\/styles\/media_large_image\/public\/In%20focus%20Immunization%201.webp?itok=rPgibAQ8)\n\n![In Focus Immunization](https:\/\/www.unicef.org\/eca\/sites\/unicef.org.eca\/files\/styles\/lazy_load\/public\/In%20focus%20Immunization%201.webp?itok=uVHIdBjk)\n\n**Convention on the Rights of the Child (1989)**\n\n- Article 24: States Parties recognize the right of the child to the enjoyment of the highest attainable standard of health and to facilities for the treatment of illness and rehabilitation of health. States Parties shall strive to ensure that no child is deprived of his or her right of access to such health care services.\n\n**Immunization Agenda 2030 (2020)**\n\nThis global strategy, endorsed by the World Health Assembly in 2020, aims for a world where everyone, everywhere, at every age, fully benefits from vaccines for good health and well-being.\n\n![Three-month-old Fotima Burizoda smiles before getting vaccinated as part of her routine childhood immunization session at a health centre in Dushanbe, Tajikistan. She will receive the rotavirus vaccine, the pentavalent vaccine, and a vaccine against Polio – OPV, which will be her second polio vaccination. “Vaccines are very important for children. They prevent them from different diseases,” says Fotima’s mother, “I don’t have any concern. The first time we came here, she had a little fever, but it passed.” ](https:\/\/www.unicef.org\/eca\/sites\/unicef.org.eca\/files\/styles\/media_large_image\/public\/UN0635905%20%281%29.webp?itok=744PqkjT)\n\n![Three-month-old Fotima Burizoda smiles before getting vaccinated as part of her routine childhood immunization session at a health centre in Dushanbe, Tajikistan. She will receive the rotavirus vaccine, the pentavalent vaccine, and a vaccine against Polio – OPV, which will be her second polio vaccination. “Vaccines are very important for children. They prevent them from different diseases,” says Fotima’s mother, “I don’t have any concern. The first time we came here, she had a little fever, but it passed.” ](https:\/\/www.unicef.org\/eca\/sites\/unicef.org.eca\/files\/styles\/lazy_load\/public\/UN0635905%20%281%29.webp?itok=NODInYh0)\n\nUNICEF\/UN0635905\/Babajanyan VII Photo  Three-month-old Fotima Burizoda smiles before getting vaccinated as part of her routine childhood immunization session at a health centre in Dushanbe, Tajikistan. She will receive the rotavirus vaccine, the pentavalent vaccine, and a vaccine against Polio – OPV, which will be her second polio vaccination. “Vaccines are very important for children. They prevent them from different diseases,” says Fotima’s mother, “I don’t have any concern. The first time we came here, she had a little fever, but it passed.” March 2022.\n\n## Challenges\nUNICEF has raised the alarm over a **surge in measles cases**, attributed to major backsliding in childhood immunization coverage. More than 1.8 million children in Europe and Central Asia have missed their measles vaccination over the past three years. The region now accounts for around half of the measles cases worldwide. There were more than 61,070 confirmed cases in the Europe and Central Asia region in 2023, up from just over 900 in 2022. And by September 2024, the European region had registered around 95,204 cases of measles, highlighting the insufficient response of the system to prevent the spread. Immunization coverage is crucial to control this crisis and safeguard the health of millions of children across the region. It is vital to address this urgent challenge, and improved immunization coverage is crucial to safeguard the health of millions of children across the region.\n\nThe **war in Ukraine** is having a devastating impact on the health and well-being of its population. Mass displacement presents public health challenges both within Ukraine and in refugee-hosting communities and increases the risk of outbreaks of vaccine-preventable disease. Efforts to maintain Europe’s ‘polio free’ status, for example, now need to accelerate and intensify, backed by action to reinforce health systems in general, and immunization in particular.\n\nImmunization **inequity continues** to hamper efforts to reach the most vulnerable children with life-saving vaccines. Roma populations across the region, for example, have lower immunization coverage than non-Roma populations. According to findings from the UNICEF Multiple Indicator Cluster Surveys (MICS) conducted in Roma settlements, stark disparities between Roma and non-Roma communities reflect major challenges in accessing essential services, including basic healthcare and immunization. In Serbia, only 70 per cent of Roma children aged 18-29 months are fully immunized, compared to 89 per cent of non-Roma children. This inequity is also seen in Kosovo1, where only 42 per cent of Roma children aged 12-23 months have received all the basic antigens, in contrast to 90 per cent of non-Roma children.\n\nSuch alarming discrepancies emphasize the **urgent need for targeted interventions** to address the substantial gaps in immunization access between different communities. They also reveal a diverse picture within countries across the region, with immunization coverage rates falling below 80 per cent in certain districts, far below safe levels. These gaps and disparities must be addressed to protect children against preventable but deadly diseases – a task that requires constant vigilance.\n\nThe **capacity of immunization programmes** needs to expand in response to the emergence of new vaccines, which – while welcome – are adding to the complexity of immunization programming. These new vaccines are vital to provide an effective barrier to the transmission of vaccine-preventable diseases, such as pneumococcal disease and rotavirus, and to protect against cervical and other forms of cancers through, for example, vaccination against human papillomavirus. However, they entail a shift from the vaccination of infants alone to vaccinations across the course of life, including infancy, childhood and adolescence, and this is stretching the capacities of immunization programmes in many places.\n\nIn addition, many countries in the region are classified as ‘middle-income’ and this has implications for their eligibility for official development assistance. There are **concerns about the financial sustainability** of their national immunization programmes, as increased national income does not guarantee that there is enough capacity for effective management.\n\nThere are also concerns about **‘vaccine hesitancy’** – a growing mistrust or even refusal of immunization among some parents, fueled by myths and misinformation. Parents’ refusal to immunize their children may stem from negative media stories that falsely link child deaths or disabilities to vaccination. It may also be influenced by unfounded fears around vaccine safety spread by anti-vaccine movements, and exacerbated by a lack of clear and consistent information for parents about the importance of immunization and its minimal risks.\n\n1 All references to Kosovo should be understood to be in the context of United Nations Security Council resolution 1244 (1999)\n\n![In Focus Immunization](https:\/\/www.unicef.org\/eca\/sites\/unicef.org.eca\/files\/styles\/media_large_image\/public\/In%20focus%20Immunization%202.webp?itok=rZY_kOtV)\n\n![In Focus Immunization](https:\/\/www.unicef.org\/eca\/sites\/unicef.org.eca\/files\/styles\/lazy_load\/public\/In%20focus%20Immunization%202.webp?itok=WvsGFOWE)\n\n![A child at Polyclinic \\#10 in Tbilisi, Georgia, undergoes routine immunization. April 2019.](https:\/\/www.unicef.org\/eca\/sites\/unicef.org.eca\/files\/styles\/media_large_image\/public\/UN0326765.webp?itok=WS5PqAkb)\n\n![A child at Polyclinic \\#10 in Tbilisi, Georgia, undergoes routine immunization. April 2019.](https:\/\/www.unicef.org\/eca\/sites\/unicef.org.eca\/files\/styles\/lazy_load\/public\/UN0326765.webp?itok=_lno2SCn)\n\nUNICEF\/UN0326765  A child at Polyclinic \\#10 in Tbilisi, Georgia, undergoes routine immunization. April 2019.\n\n## UNICEF’s work for children\nUNICEF works with governments across Europe and Central Asia to **invest in health systems** that reach the most vulnerable children with life-saving immunizations, aiming to ensure that immunization is both universal and equitable. We know how to get the right vaccines to the right children at the right time, working with our partners to deploy new techniques and strategies to reach children in need and improve health systems.\n\nWe support **the provision of quality-assured vaccines**, working with national governments, the World Health Organization, Gavi – the Vaccine Alliance, the Bill & Melinda Gates Foundation, the US and European Centers for Disease Control, and the Measles & Rubella Initiative (MRI), as well as non-governmental organizations, vaccine manufacturers and many others. We also mobilize funds and provide technical support to strengthen the development of evidence-based policies and increase the capacities of national immunization programmes, including budgeting for vaccine procurement and supply.\n\nUNICEF supports countries to **introduce new vaccines**, such as those for rotavirus, and the pneumococcal conjugate vaccine (PCV) and human papillomavirus vaccine (HPV) to protect children from a wider range of preventable diseases. We also help to strengthen the capacity of national and sub-national partners **to create demand for immunization**, aiming to address vaccine hesitancy, build public trust, tackle dangerous myths and combat misinformation.\n\nOur efforts include technical support for governments and partners on **social-science research** to gather data and other evidence. This is essential to build a greater understanding of the factors that influence vaccine hesitancy to inform communication strategies, capacity building plans for front-line health workers and community engagement. For example, we work closely with national and local authorities to reinforce the routine tracking of public perceptions and attitudes around immunization to address issues related to vaccine hesitancy and the spread of misinformation by anti-vaccine campaigners.\n\n![Edgar receives his routine vaccinations at UNICEF-supported polyclinic \\#1 in Vanadzor, Armenia. April 2021.](https:\/\/www.unicef.org\/eca\/sites\/unicef.org.eca\/files\/styles\/media_large_image\/public\/UN0452128.webp?itok=UxUpsWVV)\n\n![Edgar receives his routine vaccinations at UNICEF-supported polyclinic \\#1 in Vanadzor, Armenia. April 2021.](https:\/\/www.unicef.org\/eca\/sites\/unicef.org.eca\/files\/styles\/lazy_load\/public\/UN0452128.webp?itok=8n9uvxDK)\n\nUNICEF\/UN0452128\/Margaryan  Edgar receives his routine vaccinations at UNICEF-supported polyclinic \\#1 in Vanadzor, Armenia. April 2021.\n\n## Protecting children from polio during war\nAs the war in Ukraine continues, and people continue to flee from their homes, gaps in immunization coverage put children’s health at risk. UNICEF is working with its partners to keep vaccination going and maintain high routine coverage across the country, including the provision of catch-up vaccination for those children who have missed their scheduled vaccines.\n\nTo go the last mile in polio eradication, UNICEF implements programmes that go beyond the traditional ‘two drops’ of polio vaccine, aiming to strengthen health systems and understand the behavioural and social drivers that shape public health. Not only are these crucial and life-saving investments, they are also vital for shared global health security.\n\n“Infectious diseases do not disappear during war,” says Yuliia Dovjanych, Head Doctor at the ‘Dbayu’ medical centre. “We must continue to get vaccinated, take care of our health and the health of our children.”\n\nIn 2022, UNICEF procured more than 2 million doses of vaccines for Ukraine. In 2023, more than 650,000 doses of the polio vaccine and 657,000 doses of the combined measles-mumps-rubella vaccine were delivered, as well as almost 6.2 million syringes.\n\nUNICEF has also strengthened the cold chain, which ensures that vaccines are transported and stored at the right temperature, at all levels.\n\n- Through the COVAX initiative, UNICEF purchased 26 freezers to be installed at national and regional levels to strengthen the immunization chain.\n- Almost 5,200 vaccine refrigerators and freezers procured with World Bank funds will support safe vaccine storage at vaccination points.\n- UNICEF and USAID have also procured 36 refrigerator vans to transport vaccines from national centres to local (oblast) level and from there to vaccination points.\n- Vaccine carriers and cold boxes for vaccine storage and transportation have been provided for over 2,500 vaccination points and 800 mobile teams have been operating across Ukraine.\n\nEven in the most complex conflict settings, UNICEF and its partners know how to prevent catastrophic disease outbreak and are determined to make polio history.\n\n![All vaccines at the health centre in Kyiv’s Shevchenkivskyi district, Ukraine, are stored in a specialized refrigerator provided by UNICEF. This keeps them at the optimal temperature of +2 to +8°C, even during power outages. May 2024.](https:\/\/www.unicef.org\/eca\/sites\/unicef.org.eca\/files\/styles\/media_large_image\/public\/In%20focus%20Immunization%203.webp?itok=BXaD5PM3)\n\n![All vaccines at the health centre in Kyiv’s Shevchenkivskyi district, Ukraine, are stored in a specialized refrigerator provided by UNICEF. This keeps them at the optimal temperature of +2 to +8°C, even during power outages. May 2024.](https:\/\/www.unicef.org\/eca\/sites\/unicef.org.eca\/files\/styles\/lazy_load\/public\/In%20focus%20Immunization%203.webp?itok=0WOr1m-p)\n\nUNICEF\/UNI601165\/Vashkiv   All vaccines at the health centre in Kyiv’s Shevchenkivskyi district, Ukraine, are stored in a specialized refrigerator provided by UNICEF. This keeps them at the optimal temperature of +2 to +8°C, even during power outages. May 2024.\n\n## Uzbekistan: HPV vaccination across generations\nNargiza received her first HPV vaccine shot at her school in Tashkent city, Uzbekistan, when she was 16. A doctor visited her school to tell the students that the vaccine would protect them from cancers and assured them of its safety.\n\n“I remember there were rumours that your fertility could be impacted, but I understood that the purpose of vaccines is to prevent disease,” Nargiza said.\n\n> “I had no doubts about receiving the shot.”\n\nNargiza put her faith in scientific facts. After receiving her dose she had a mild headache –   \na common side effect and a small sacrifice for her peace of mind.\n\nNow aged 26 and still living in Tashkent, Nargiza is protecting her whole family against preventable illness through vaccines given to her children at the prescribed ages. While her daughters aged 2 and 4 aren’t old enough to have the HPV vaccine, they have had all their other vaccinations at the right time.\n\nNargiza is creating a lasting tradition of vaccination in her family. She advocates that vaccines protect against preventable illnesses such as COVID-19, and against the human papillomavirus (HPV). While misinformation still abounds about vaccines and their side effects, she knows they exist only to protect people’s health and well-being.\n\nYet the phenomenon known as ‘vaccine hesitancy’ persists. This fear of vaccines is founded on misinformation and dangerous myths, and UNICEF and its partners are fully committed to overcoming it. UNICEF is working with the World Health Organization and the Uzbekistan Ministry of Health to raise public awareness of vaccine-preventable diseases by, for example, sharing a range of information materials to help healthcare providers communicate with parents and caregivers and answer their frequently asked questions.\n\nTV shows, radio programmes and public service announcements on national and regional channels encourage parents to trust immunization services and protect children from preventable diseases.\n\n> “Vaccines train our bodies – train our immune systems – to be ready to fight illness. This is what I tell people who don’t want to get vaccinated. All people should vaccinate their children and themselves. It’s our best protection.”\n\n![Alina, 9, sits with her mother at the Samarkand City Family Clinic. She has just received her first HPV vaccination administered by Vaccination Nurse Shoira Gafurova. Alina recently finished third grade. June 2022.](https:\/\/www.unicef.org\/eca\/sites\/unicef.org.eca\/files\/styles\/media_large_image\/public\/UN0687771%20%281%29.webp?itok=9uWyyQCX)\n\n![Alina, 9, sits with her mother at the Samarkand City Family Clinic. She has just received her first HPV vaccination administered by Vaccination Nurse Shoira Gafurova. Alina recently finished third grade. June 2022.](https:\/\/www.unicef.org\/eca\/sites\/unicef.org.eca\/files\/styles\/lazy_load\/public\/UN0687771%20%281%29.webp?itok=iTAXVo31)\n\nUNICEF\/UN0687771\/Babajanyan VII Photo  Alina, 9, sits with her mother at the Samarkand City Family Clinic. She has just received her first HPV vaccination administered by Vaccination Nurse Shoira Gafurova. Alina recently finished third grade. June 2022.\n\n## Call to action\nLow vaccination rates and ongoing measles outbreaks in the region call for vigilance and greater efforts to improve universal routine immunization to protect children. Immunization strategies need to be tailored to reach all ‘zero dose’ and under-vaccinated children, including those in marginalized communities where the services are inadequate; those who may have become disconnected from services or are unreached by them; and those affected by conflict and insecurity.\n\nUNICEF is urging countries across the region to:\n\n- urgently identify and reach all children with immunization, especially those who have missed vaccinations\n- strengthen demand for vaccines, including by building confidence\n- prioritize funding to immunization services and primary health care\n- build resilient health systems through investment in health workers, innovation and local manufacturing to ensure robust local action that reaches everyone, everywhere with vaccines.\n\nOne of UNICEF’s primary goals is to create an enabling environment for immunization and primary health care by 2030. This involves developing supportive policies, strengthening health systems, and fostering community engagement to lay a strong foundation for effective health services. Another critical objective is to enhance equitable access to quality immunization services. UNICEF aims to ensure that all individuals, particularly those who are the most vulnerable, can benefit from high-quality immunization services provided through resilient and well-supported primary health care systems.\n\nImmunization 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.\n\nUNICEF has a long history of bringing stakeholders together to safeguard and promote immunization, both globally and in the Europe and Central Asia Region. We will continue to work with partners to strengthen routine immunization systems and step in whenever necessary to bolster immunization. The task ahead is to ensure fully sustainable, well-resourced and managed immunization systems that guarantee vaccinations for each and every child – with no exceptions.\n\n![Dilbar (left), Chief Physician at the Samarkand City Family Clinic \\#2, and Parvina, Patronage Nurse (second from left), walk with 11-year-old Leila and her mother Mukharram, visiting them at their home in Samarkand, Uzbekistan, on 29 June 2022. Leila recently finished fourth grade, and has just received her second dose of the HPV vaccine. April 2022.](https:\/\/www.unicef.org\/eca\/sites\/unicef.org.eca\/files\/styles\/media_large_image\/public\/UN0687706.webp?itok=ybj9-oyH)\n\n![Dilbar (left), Chief Physician at the Samarkand City Family Clinic \\#2, and Parvina, Patronage Nurse (second from left), walk with 11-year-old Leila and her mother Mukharram, visiting them at their home in Samarkand, Uzbekistan, on 29 June 2022. Leila recently finished fourth grade, and has just received her second dose of the HPV vaccine. April 2022.](https:\/\/www.unicef.org\/eca\/sites\/unicef.org.eca\/files\/styles\/lazy_load\/public\/UN0687706.webp?itok=n39fSU8q)\n\nUNICEF\/UN0687706\/Babajanyan VII Photo  Dilbar (left), Chief Physician at the Samarkand City Family Clinic \\#2, and Parvina, Patronage Nurse (second from left), walk with 11-year-old Leila and her mother Mukharram, visiting them at their home in Samarkand, Uzbekistan, on 29 June 2022. Leila recently finished fourth grade, and has just received her second dose of the HPV vaccine. April 2022.\n\n## Related topics\n- [Health](https:\/\/www.unicef.org\/eca\/topics\/health)\n- [Immunization](https:\/\/www.unicef.org\/eca\/topics\/immunization)\n\n## More to explore\n![](https:\/\/www.unicef.org\/eca\/sites\/unicef.org.eca\/files\/styles\/large\/public\/UN0450955.webp?itok=Xd3uY1Ln)\n\nPress release\n\n11 February 2026\n### [Measles cases dropped in Europe and Central Asia in 2025 compared to the previous year, but the risk of outbreaks remains – UNICEF and WHO](https:\/\/www.unicef.org\/eca\/press-releases\/measles-cases-dropped-europe-and-central-asia-2025-compared-previous-year-risk \"Measles cases dropped in Europe and Central Asia in 2025 compared to the previous year, but the risk of outbreaks remains – UNICEF and WHO\")\nRead now\n\n![](https:\/\/www.unicef.org\/eca\/sites\/unicef.org.eca\/files\/styles\/large\/public\/UNI730983.webp?itok=FObRz5_7)\n\nArticle\n\n### [Charting a healthier tomorrow for Europe's children](https:\/\/www.unicef.org\/eca\/stories\/charting-healthier-tomorrow-europes-children-and-adolescents \"Charting a healthier tomorrow for Europe's children\")\nDespite Europe’s wealth, resources and high standards of living, the region’s children are being left behind - The Lancet\n\nRead now\n\n![](https:\/\/www.unicef.org\/eca\/sites\/unicef.org.eca\/files\/styles\/large\/public\/UNI809830.webp?itok=F-wDjUTj)\n\nPress release\n\n15 July 2025\n### [Childhood vaccination rates lag in Europe – fueling further resurgence of measles and whooping cough](https:\/\/www.unicef.org\/eca\/press-releases\/childhood-vaccination-rates-lag-europe-fueling-further-resurgence-measles-and \"Childhood vaccination rates lag in Europe – fueling further resurgence of measles and whooping cough\")\nRead now\n\n![](https:\/\/www.unicef.org\/eca\/sites\/unicef.org.eca\/files\/styles\/large\/public\/DSC02897%20%281%29.webp?itok=1zAFrQ9-)\n\nPress release\n\n26 June 2025\n### [Chief Sanitary Inspectorate establishes the first Behavioural Science Team for Public Health in Poland](https:\/\/www.unicef.org\/eca\/press-releases\/chief-sanitary-inspectorate-establishes-first-behavioural-science-team-public-health \"Chief Sanitary Inspectorate establishes the first Behavioural Science Team for Public Health in Poland \")\nRead now\n\n## [UNICEF Home](https:\/\/www.unicef.org\/eca\/ \"UNICEF Home\")\n- [What we do](https:\/\/www.unicef.org\/eca\/what-we-do \"What we do\")\n- [Situation for children](https:\/\/www.unicef.org\/eca\/situation-children-europe-and-central-asia \"Situation for children\")\n- [Where we work](https:\/\/www.unicef.org\/eca\/where-we-work \"Where we work\")\n\n## [Data, Research and Reports](https:\/\/www.unicef.org\/eca\/research-and-reports \"Data, Research and Reports\")\n- [Publications](https:\/\/www.unicef.org\/eca\/research-and-reports\/publications \"Publications\")\n- [Ambassadors and Supporters](https:\/\/www.unicef.org\/eca\/unicef-ambassadors-europe-and-central-asia \"Ambassadors and Supporters\")\n\n[Become a donor](https:\/\/help.unicef.org\/)\n\n- [Visit us on Facebook](https:\/\/www.facebook.com\/unicefeca)\n- [Visit us on Instagram](https:\/\/www.instagram.com\/unicefecaro\/)\n- [Visit us on LinkedIn](https:\/\/www.linkedin.com\/company\/unicefecaro)\n- [Visit us on TikTok](https:\/\/www.tiktok.com\/@unicefeca)\n- [Visit us on Twitter](https:\/\/twitter.com\/unicef_eca)\n- [Visit us on YouTube](https:\/\/www.youtube.com\/@UNICEFECA)\n\n- [Contact us](https:\/\/www.unicef.org\/eca\/contact-us)\n- [Legal](https:\/\/www.unicef.org\/legal)\n\n[Report fraud, abuse, wrongdoing](https:\/\/www.unicef.org\/auditandinvestigation\/report-wrongdoing)\n\nCookie settings\n\nUNICEF strives to uphold the rights of every child, protecting them from harm and all forms of discrimination, so that they can grow up healthy and educated to reach their full potential. This work is in line with UNICEF’s globally recognized mandate and its support of national priorities.","attrs_readable_markdown":"Flagship report\n\nPromoting and strengthening a life-saving investment\n\nUNICEF\/UN0635915\/Babajanyan VII Photo\n\n### Highlights\n### Immunization is one of the world’s most cost-effective public health interventions, preventing an estimated 4.4 million deaths each year, and protecting millions of children from preventable illness and disability.\nYet, global childhood immunization coverage stalled in 2023, and the number of children worldwide who are under-vaccinated or not vaccinated at all has increased by 2.7 million since 2019, before the COVID-19 pandemic.\n\nIn Europe and Central Asia, coverage of the first dose of the diphtheria-tetanus-pertussis (DTP1) vaccine in 2023 had recovered to its pre-pandemic level (2019) of 97 per cent. Coverage of the third dose (DTP3) – seen as the benchmark for the strength of routine immunization services – has also reached its pre-pandemic level, rising from 93 per cent in 2021 to 95 per cent.\n\nYet 400,000 fewer children were vaccinated with DTP1 in the region in 2023 than in 2019, and 123,000 children remain completely unvaccinated. These ‘zero dose’ children remain vulnerable to, and unprotected from, measles, diphtheria and other life-threatening – but entirely preventable – diseases. There are also serious concerns about a surge in measles cases.\n\nA global strategy is in place – Immunization Agenda 2030 – to make vaccination available to everyone, everywhere, by the end of this decade. The challenge ahead is to fully reinvigorate immunization systems in the aftermath of the pandemic. This means closing the remaining coverage gaps within countries; ensuring effective immunization for the unprecedented numbers of children on the move across the region; and tackling the persistent ‘vaccine hesitancy’ that is fuelled by misinformation.\n\nUNICEF knows that every child benefits when all countries achieve and maintain high vaccine coverage across their entire territory. We work with governments, international agencies, non-governmental organizations and vaccine manufacturers to strengthen health systems and ensure supplies of life-saving vaccines for all children. We also aim to increase demand for immunization, educating the public on its importance, and equipping parents and communities with the knowledge they need to protect their children.\n\nPublication date\n\nNovember 2024\n\nLanguages\n\nEnglish\n\nKey policy frameworks\n\n**Convention on the Rights of the Child (1989)**\n\n- Article 24: States Parties recognize the right of the child to the enjoyment of the highest attainable standard of health and to facilities for the treatment of illness and rehabilitation of health. States Parties shall strive to ensure that no child is deprived of his or her right of access to such health care services.\n\n**Immunization Agenda 2030 (2020)**\n\nThis global strategy, endorsed by the World Health Assembly in 2020, aims for a world where everyone, everywhere, at every age, fully benefits from vaccines for good health and well-being.\n\nChallenges\n\nUNICEF has raised the alarm over a **surge in measles cases**, attributed to major backsliding in childhood immunization coverage. More than 1.8 million children in Europe and Central Asia have missed their measles vaccination over the past three years. The region now accounts for around half of the measles cases worldwide. There were more than 61,070 confirmed cases in the Europe and Central Asia region in 2023, up from just over 900 in 2022. And by September 2024, the European region had registered around 95,204 cases of measles, highlighting the insufficient response of the system to prevent the spread. Immunization coverage is crucial to control this crisis and safeguard the health of millions of children across the region. It is vital to address this urgent challenge, and improved immunization coverage is crucial to safeguard the health of millions of children across the region.\n\nThe **war in Ukraine** is having a devastating impact on the health and well-being of its population. Mass displacement presents public health challenges both within Ukraine and in refugee-hosting communities and increases the risk of outbreaks of vaccine-preventable disease. Efforts to maintain Europe’s ‘polio free’ status, for example, now need to accelerate and intensify, backed by action to reinforce health systems in general, and immunization in particular.\n\nImmunization **inequity continues** to hamper efforts to reach the most vulnerable children with life-saving vaccines. Roma populations across the region, for example, have lower immunization coverage than non-Roma populations. According to findings from the UNICEF Multiple Indicator Cluster Surveys (MICS) conducted in Roma settlements, stark disparities between Roma and non-Roma communities reflect major challenges in accessing essential services, including basic healthcare and immunization. In Serbia, only 70 per cent of Roma children aged 18-29 months are fully immunized, compared to 89 per cent of non-Roma children. This inequity is also seen in Kosovo1, where only 42 per cent of Roma children aged 12-23 months have received all the basic antigens, in contrast to 90 per cent of non-Roma children.\n\nSuch alarming discrepancies emphasize the **urgent need for targeted interventions** to address the substantial gaps in immunization access between different communities. They also reveal a diverse picture within countries across the region, with immunization coverage rates falling below 80 per cent in certain districts, far below safe levels. These gaps and disparities must be addressed to protect children against preventable but deadly diseases – a task that requires constant vigilance.\n\nThe **capacity of immunization programmes** needs to expand in response to the emergence of new vaccines, which – while welcome – are adding to the complexity of immunization programming. These new vaccines are vital to provide an effective barrier to the transmission of vaccine-preventable diseases, such as pneumococcal disease and rotavirus, and to protect against cervical and other forms of cancers through, for example, vaccination against human papillomavirus. However, they entail a shift from the vaccination of infants alone to vaccinations across the course of life, including infancy, childhood and adolescence, and this is stretching the capacities of immunization programmes in many places.\n\nIn addition, many countries in the region are classified as ‘middle-income’ and this has implications for their eligibility for official development assistance. There are **concerns about the financial sustainability** of their national immunization programmes, as increased national income does not guarantee that there is enough capacity for effective management.\n\nThere are also concerns about **‘vaccine hesitancy’** – a growing mistrust or even refusal of immunization among some parents, fueled by myths and misinformation. Parents’ refusal to immunize their children may stem from negative media stories that falsely link child deaths or disabilities to vaccination. It may also be influenced by unfounded fears around vaccine safety spread by anti-vaccine movements, and exacerbated by a lack of clear and consistent information for parents about the importance of immunization and its minimal risks.\n\n1 All references to Kosovo should be understood to be in the context of United Nations Security Council resolution 1244 (1999)\n\nUNICEF’s work for children\n\nUNICEF works with governments across Europe and Central Asia to **invest in health systems** that reach the most vulnerable children with life-saving immunizations, aiming to ensure that immunization is both universal and equitable. We know how to get the right vaccines to the right children at the right time, working with our partners to deploy new techniques and strategies to reach children in need and improve health systems.\n\nWe support **the provision of quality-assured vaccines**, working with national governments, the World Health Organization, Gavi – the Vaccine Alliance, the Bill & Melinda Gates Foundation, the US and European Centers for Disease Control, and the Measles & Rubella Initiative (MRI), as well as non-governmental organizations, vaccine manufacturers and many others. We also mobilize funds and provide technical support to strengthen the development of evidence-based policies and increase the capacities of national immunization programmes, including budgeting for vaccine procurement and supply.\n\nUNICEF supports countries to **introduce new vaccines**, such as those for rotavirus, and the pneumococcal conjugate vaccine (PCV) and human papillomavirus vaccine (HPV) to protect children from a wider range of preventable diseases. We also help to strengthen the capacity of national and sub-national partners **to create demand for immunization**, aiming to address vaccine hesitancy, build public trust, tackle dangerous myths and combat misinformation.\n\nOur efforts include technical support for governments and partners on **social-science research** to gather data and other evidence. This is essential to build a greater understanding of the factors that influence vaccine hesitancy to inform communication strategies, capacity building plans for front-line health workers and community engagement. For example, we work closely with national and local authorities to reinforce the routine tracking of public perceptions and attitudes around immunization to address issues related to vaccine hesitancy and the spread of misinformation by anti-vaccine campaigners.\n\nProtecting children from polio during war\n\nAs the war in Ukraine continues, and people continue to flee from their homes, gaps in immunization coverage put children’s health at risk. UNICEF is working with its partners to keep vaccination going and maintain high routine coverage across the country, including the provision of catch-up vaccination for those children who have missed their scheduled vaccines.\n\nTo go the last mile in polio eradication, UNICEF implements programmes that go beyond the traditional ‘two drops’ of polio vaccine, aiming to strengthen health systems and understand the behavioural and social drivers that shape public health. Not only are these crucial and life-saving investments, they are also vital for shared global health security.\n\n“Infectious diseases do not disappear during war,” says Yuliia Dovjanych, Head Doctor at the ‘Dbayu’ medical centre. “We must continue to get vaccinated, take care of our health and the health of our children.”\n\nIn 2022, UNICEF procured more than 2 million doses of vaccines for Ukraine. In 2023, more than 650,000 doses of the polio vaccine and 657,000 doses of the combined measles-mumps-rubella vaccine were delivered, as well as almost 6.2 million syringes.\n\nUNICEF has also strengthened the cold chain, which ensures that vaccines are transported and stored at the right temperature, at all levels.\n\n- Through the COVAX initiative, UNICEF purchased 26 freezers to be installed at national and regional levels to strengthen the immunization chain.\n- Almost 5,200 vaccine refrigerators and freezers procured with World Bank funds will support safe vaccine storage at vaccination points.\n- UNICEF and USAID have also procured 36 refrigerator vans to transport vaccines from national centres to local (oblast) level and from there to vaccination points.\n- Vaccine carriers and cold boxes for vaccine storage and transportation have been provided for over 2,500 vaccination points and 800 mobile teams have been operating across Ukraine.\n\nEven in the most complex conflict settings, UNICEF and its partners know how to prevent catastrophic disease outbreak and are determined to make polio history.\n\nUzbekistan: HPV vaccination across generations\n\nNargiza received her first HPV vaccine shot at her school in Tashkent city, Uzbekistan, when she was 16. A doctor visited her school to tell the students that the vaccine would protect them from cancers and assured them of its safety.\n\n“I remember there were rumours that your fertility could be impacted, but I understood that the purpose of vaccines is to prevent disease,” Nargiza said.\n\n> “I had no doubts about receiving the shot.”\n\nNargiza put her faith in scientific facts. After receiving her dose she had a mild headache –   \na common side effect and a small sacrifice for her peace of mind.\n\nNow aged 26 and still living in Tashkent, Nargiza is protecting her whole family against preventable illness through vaccines given to her children at the prescribed ages. While her daughters aged 2 and 4 aren’t old enough to have the HPV vaccine, they have had all their other vaccinations at the right time.\n\nNargiza is creating a lasting tradition of vaccination in her family. She advocates that vaccines protect against preventable illnesses such as COVID-19, and against the human papillomavirus (HPV). While misinformation still abounds about vaccines and their side effects, she knows they exist only to protect people’s health and well-being.\n\nYet the phenomenon known as ‘vaccine hesitancy’ persists. This fear of vaccines is founded on misinformation and dangerous myths, and UNICEF and its partners are fully committed to overcoming it. UNICEF is working with the World Health Organization and the Uzbekistan Ministry of Health to raise public awareness of vaccine-preventable diseases by, for example, sharing a range of information materials to help healthcare providers communicate with parents and caregivers and answer their frequently asked questions.\n\nTV shows, radio programmes and public service announcements on national and regional channels encourage parents to trust immunization services and protect children from preventable diseases.\n\n> “Vaccines train our bodies – train our immune systems – to be ready to fight illness. This is what I tell people who don’t want to get vaccinated. All people should vaccinate their children and themselves. It’s our best protection.”\n\nCall to action\n\nLow vaccination rates and ongoing measles outbreaks in the region call for vigilance and greater efforts to improve universal routine immunization to protect children. Immunization strategies need to be tailored to reach all ‘zero dose’ and under-vaccinated children, including those in marginalized communities where the services are inadequate; those who may have become disconnected from services or are unreached by them; and those affected by conflict and insecurity.\n\nUNICEF is urging countries across the region to:\n\n- urgently identify and reach all children with immunization, especially those who have missed vaccinations\n- strengthen demand for vaccines, including by building confidence\n- prioritize funding to immunization services and primary health care\n- build resilient health systems through investment in health workers, innovation and local manufacturing to ensure robust local action that reaches everyone, everywhere with vaccines.\n\nOne of UNICEF’s primary goals is to create an enabling environment for immunization and primary health care by 2030. This involves developing supportive policies, strengthening health systems, and fostering community engagement to lay a strong foundation for effective health services. Another critical objective is to enhance equitable access to quality immunization services. UNICEF aims to ensure that all individuals, particularly those who are the most vulnerable, can benefit from high-quality immunization services provided through resilient and well-supported primary health care systems.\n\nImmunization 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.\n\nUNICEF has a long history of bringing stakeholders together to safeguard and promote immunization, both globally and in the Europe and Central Asia Region. We will continue to work with partners to strengthen routine immunization systems and step in whenever necessary to bolster immunization. The task ahead is to ensure fully sustainable, well-resourced and managed immunization systems that guarantee vaccinations for each and every child – with no exceptions.","meta_canonical":null}

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Boilerpipe Text	Flagship report Promoting and strengthening a life-saving investment UNICEF/UN0635915/Babajanyan VII Photo Highlights Immunization is one of the world’s most cost-effective public health interventions, preventing an estimated 4.4 million deaths each year, and protecting millions of children from preventable illness and disability. Yet, global childhood immunization coverage stalled in 2023, and the number of children worldwide who are under-vaccinated or not vaccinated at all has increased by 2.7 million since 2019, before the COVID-19 pandemic. In Europe and Central Asia, coverage of the first dose of the diphtheria-tetanus-pertussis (DTP1) vaccine in 2023 had recovered to its pre-pandemic level (2019) of 97 per cent. Coverage of the third dose (DTP3) – seen as the benchmark for the strength of routine immunization services – has also reached its pre-pandemic level, rising from 93 per cent in 2021 to 95 per cent. Yet 400,000 fewer children were vaccinated with DTP1 in the region in 2023 than in 2019, and 123,000 children remain completely unvaccinated. These ‘zero dose’ children remain vulnerable to, and unprotected from, measles, diphtheria and other life-threatening – but entirely preventable – diseases. There are also serious concerns about a surge in measles cases. A global strategy is in place – Immunization Agenda 2030 – to make vaccination available to everyone, everywhere, by the end of this decade. The challenge ahead is to fully reinvigorate immunization systems in the aftermath of the pandemic. This means closing the remaining coverage gaps within countries; ensuring effective immunization for the unprecedented numbers of children on the move across the region; and tackling the persistent ‘vaccine hesitancy’ that is fuelled by misinformation. UNICEF knows that every child benefits when all countries achieve and maintain high vaccine coverage across their entire territory. We work with governments, international agencies, non-governmental organizations and vaccine manufacturers to strengthen health systems and ensure supplies of life-saving vaccines for all children. We also aim to increase demand for immunization, educating the public on its importance, and equipping parents and communities with the knowledge they need to protect their children. Publication date November 2024 Languages English Key policy frameworks Convention on the Rights of the Child (1989) Article 24: States Parties recognize the right of the child to the enjoyment of the highest attainable standard of health and to facilities for the treatment of illness and rehabilitation of health. States Parties shall strive to ensure that no child is deprived of his or her right of access to such health care services. Immunization Agenda 2030 (2020) This global strategy, endorsed by the World Health Assembly in 2020, aims for a world where everyone, everywhere, at every age, fully benefits from vaccines for good health and well-being. Challenges UNICEF has raised the alarm over a surge in measles cases , attributed to major backsliding in childhood immunization coverage. More than 1.8 million children in Europe and Central Asia have missed their measles vaccination over the past three years. The region now accounts for around half of the measles cases worldwide. There were more than 61,070 confirmed cases in the Europe and Central Asia region in 2023, up from just over 900 in 2022. And by September 2024, the European region had registered around 95,204 cases of measles, highlighting the insufficient response of the system to prevent the spread. Immunization coverage is crucial to control this crisis and safeguard the health of millions of children across the region. It is vital to address this urgent challenge, and improved immunization coverage is crucial to safeguard the health of millions of children across the region. The war in Ukraine is having a devastating impact on the health and well-being of its population. Mass displacement presents public health challenges both within Ukraine and in refugee-hosting communities and increases the risk of outbreaks of vaccine-preventable disease. Efforts to maintain Europe’s ‘polio free’ status, for example, now need to accelerate and intensify, backed by action to reinforce health systems in general, and immunization in particular. Immunization inequity continues to hamper efforts to reach the most vulnerable children with life-saving vaccines. Roma populations across the region, for example, have lower immunization coverage than non-Roma populations. According to findings from the UNICEF Multiple Indicator Cluster Surveys (MICS) conducted in Roma settlements, stark disparities between Roma and non-Roma communities reflect major challenges in accessing essential services, including basic healthcare and immunization. In Serbia, only 70 per cent of Roma children aged 18-29 months are fully immunized, compared to 89 per cent of non-Roma children. This inequity is also seen in Kosovo 1 , where only 42 per cent of Roma children aged 12-23 months have received all the basic antigens, in contrast to 90 per cent of non-Roma children. Such alarming discrepancies emphasize the urgent need for targeted interventions to address the substantial gaps in immunization access between different communities. They also reveal a diverse picture within countries across the region, with immunization coverage rates falling below 80 per cent in certain districts, far below safe levels. These gaps and disparities must be addressed to protect children against preventable but deadly diseases – a task that requires constant vigilance. The capacity of immunization programmes needs to expand in response to the emergence of new vaccines, which – while welcome – are adding to the complexity of immunization programming. These new vaccines are vital to provide an effective barrier to the transmission of vaccine-preventable diseases, such as pneumococcal disease and rotavirus, and to protect against cervical and other forms of cancers through, for example, vaccination against human papillomavirus. However, they entail a shift from the vaccination of infants alone to vaccinations across the course of life, including infancy, childhood and adolescence, and this is stretching the capacities of immunization programmes in many places. In addition, many countries in the region are classified as ‘middle-income’ and this has implications for their eligibility for official development assistance. There are concerns about the financial sustainability of their national immunization programmes, as increased national income does not guarantee that there is enough capacity for effective management. There are also concerns about ‘vaccine hesitancy’ – a growing mistrust or even refusal of immunization among some parents, fueled by myths and misinformation. Parents’ refusal to immunize their children may stem from negative media stories that falsely link child deaths or disabilities to vaccination. It may also be influenced by unfounded fears around vaccine safety spread by anti-vaccine movements, and exacerbated by a lack of clear and consistent information for parents about the importance of immunization and its minimal risks. 1 All references to Kosovo should be understood to be in the context of United Nations Security Council resolution 1244 (1999) UNICEF’s work for children UNICEF works with governments across Europe and Central Asia to invest in health systems that reach the most vulnerable children with life-saving immunizations, aiming to ensure that immunization is both universal and equitable. We know how to get the right vaccines to the right children at the right time, working with our partners to deploy new techniques and strategies to reach children in need and improve health systems. We support the provision of quality-assured vaccines , working with national governments, the World Health Organization, Gavi – the Vaccine Alliance, the Bill & Melinda Gates Foundation, the US and European Centers for Disease Control, and the Measles & Rubella Initiative (MRI), as well as non-governmental organizations, vaccine manufacturers and many others. We also mobilize funds and provide technical support to strengthen the development of evidence-based policies and increase the capacities of national immunization programmes, including budgeting for vaccine procurement and supply. UNICEF supports countries to introduce new vaccines , such as those for rotavirus, and the pneumococcal conjugate vaccine (PCV) and human papillomavirus vaccine (HPV) to protect children from a wider range of preventable diseases. We also help to strengthen the capacity of national and sub-national partners to create demand for immunization , aiming to address vaccine hesitancy, build public trust, tackle dangerous myths and combat misinformation. Our efforts include technical support for governments and partners on social-science research to gather data and other evidence. This is essential to build a greater understanding of the factors that influence vaccine hesitancy to inform communication strategies, capacity building plans for front-line health workers and community engagement. For example, we work closely with national and local authorities to reinforce the routine tracking of public perceptions and attitudes around immunization to address issues related to vaccine hesitancy and the spread of misinformation by anti-vaccine campaigners. Protecting children from polio during war As the war in Ukraine continues, and people continue to flee from their homes, gaps in immunization coverage put children’s health at risk. UNICEF is working with its partners to keep vaccination going and maintain high routine coverage across the country, including the provision of catch-up vaccination for those children who have missed their scheduled vaccines. To go the last mile in polio eradication, UNICEF implements programmes that go beyond the traditional ‘two drops’ of polio vaccine, aiming to strengthen health systems and understand the behavioural and social drivers that shape public health. Not only are these crucial and life-saving investments, they are also vital for shared global health security. “Infectious diseases do not disappear during war,” says Yuliia Dovjanych, Head Doctor at the ‘Dbayu’ medical centre. “We must continue to get vaccinated, take care of our health and the health of our children.” In 2022, UNICEF procured more than 2 million doses of vaccines for Ukraine. In 2023, more than 650,000 doses of the polio vaccine and 657,000 doses of the combined measles-mumps-rubella vaccine were delivered, as well as almost 6.2 million syringes. UNICEF has also strengthened the cold chain, which ensures that vaccines are transported and stored at the right temperature, at all levels. Through the COVAX initiative, UNICEF purchased 26 freezers to be installed at national and regional levels to strengthen the immunization chain. Almost 5,200 vaccine refrigerators and freezers procured with World Bank funds will support safe vaccine storage at vaccination points. UNICEF and USAID have also procured 36 refrigerator vans to transport vaccines from national centres to local (oblast) level and from there to vaccination points. Vaccine carriers and cold boxes for vaccine storage and transportation have been provided for over 2,500 vaccination points and 800 mobile teams have been operating across Ukraine. Even in the most complex conflict settings, UNICEF and its partners know how to prevent catastrophic disease outbreak and are determined to make polio history. Uzbekistan: HPV vaccination across generations Nargiza received her first HPV vaccine shot at her school in Tashkent city, Uzbekistan, when she was 16. A doctor visited her school to tell the students that the vaccine would protect them from cancers and assured them of its safety. “I remember there were rumours that your fertility could be impacted, but I understood that the purpose of vaccines is to prevent disease,” Nargiza said. “I had no doubts about receiving the shot.” Nargiza put her faith in scientific facts. After receiving her dose she had a mild headache – a common side effect and a small sacrifice for her peace of mind. Now aged 26 and still living in Tashkent, Nargiza is protecting her whole family against preventable illness through vaccines given to her children at the prescribed ages. While her daughters aged 2 and 4 aren’t old enough to have the HPV vaccine, they have had all their other vaccinations at the right time. Nargiza is creating a lasting tradition of vaccination in her family. She advocates that vaccines protect against preventable illnesses such as COVID-19, and against the human papillomavirus (HPV). While misinformation still abounds about vaccines and their side effects, she knows they exist only to protect people’s health and well-being. Yet the phenomenon known as ‘vaccine hesitancy’ persists. This fear of vaccines is founded on misinformation and dangerous myths, and UNICEF and its partners are fully committed to overcoming it. UNICEF is working with the World Health Organization and the Uzbekistan Ministry of Health to raise public awareness of vaccine-preventable diseases by, for example, sharing a range of information materials to help healthcare providers communicate with parents and caregivers and answer their frequently asked questions. TV shows, radio programmes and public service announcements on national and regional channels encourage parents to trust immunization services and protect children from preventable diseases. “Vaccines train our bodies – train our immune systems – to be ready to fight illness. This is what I tell people who don’t want to get vaccinated. All people should vaccinate their children and themselves. It’s our best protection.” Call to action Low vaccination rates and ongoing measles outbreaks in the region call for vigilance and greater efforts to improve universal routine immunization to protect children. Immunization strategies need to be tailored to reach all ‘zero dose’ and under-vaccinated children, including those in marginalized communities where the services are inadequate; those who may have become disconnected from services or are unreached by them; and those affected by conflict and insecurity. UNICEF is urging countries across the region to: urgently identify and reach all children with immunization, especially those who have missed vaccinations strengthen demand for vaccines, including by building confidence prioritize funding to immunization services and primary health care build resilient health systems through investment in health workers, innovation and local manufacturing to ensure robust local action that reaches everyone, everywhere with vaccines. One of UNICEF’s primary goals is to create an enabling environment for immunization and primary health care by 2030. This involves developing supportive policies, strengthening health systems, and fostering community engagement to lay a strong foundation for effective health services. Another critical objective is to enhance equitable access to quality immunization services. UNICEF aims to ensure that all individuals, particularly those who are the most vulnerable, can benefit from high-quality immunization services provided through resilient and well-supported primary health care systems. 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. 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 will continue to work with partners to strengthen routine immunization systems and step in whenever necessary to bolster immunization. The task ahead is to ensure fully sustainable, well-resourced and managed immunization systems that guarantee vaccinations for each and every child – with no exceptions.
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Search area has opened. SearchClose Search form Flagship report # In Focus: Immunization Promoting and strengthening a life-saving investment ![Six-year old Muso Ahliddinzoda smiles as he looks down at his arm, held by his father, after the boy has his routine vaccinations at a health centre in Dushanbe, Tajikistan. March 2022.](https://www.unicef.org/eca/sites/unicef.org.eca/files/styles/hero_extended/public/UN0635915%20%281%29.webp?itok=YRiZ0eO2) ![Six-year old Muso Ahliddinzoda smiles as he looks down at his arm, held by his father, after the boy has his routine vaccinations at a health centre in Dushanbe, Tajikistan. March 2022.](https://www.unicef.org/eca/sites/unicef.org.eca/files/styles/lazy_load/public/UN0635915%20%281%29.webp?itok=fKD7kj6H) UNICEF/UN0635915/Babajanyan VII Photo ### Highlights ### Immunization is one of the world’s most cost-effective public health interventions, preventing an estimated 4.4 million deaths each year, and protecting millions of children from preventable illness and disability. Yet, global childhood immunization coverage stalled in 2023, and the number of children worldwide who are under-vaccinated or not vaccinated at all has increased by 2.7 million since 2019, before the COVID-19 pandemic. In Europe and Central Asia, coverage of the first dose of the diphtheria-tetanus-pertussis (DTP1) vaccine in 2023 had recovered to its pre-pandemic level (2019) of 97 per cent. Coverage of the third dose (DTP3) – seen as the benchmark for the strength of routine immunization services – has also reached its pre-pandemic level, rising from 93 per cent in 2021 to 95 per cent. Yet 400,000 fewer children were vaccinated with DTP1 in the region in 2023 than in 2019, and 123,000 children remain completely unvaccinated. These ‘zero dose’ children remain vulnerable to, and unprotected from, measles, diphtheria and other life-threatening – but entirely preventable – diseases. There are also serious concerns about a surge in measles cases. A global strategy is in place – Immunization Agenda 2030 – to make vaccination available to everyone, everywhere, by the end of this decade. The challenge ahead is to fully reinvigorate immunization systems in the aftermath of the pandemic. This means closing the remaining coverage gaps within countries; ensuring effective immunization for the unprecedented numbers of children on the move across the region; and tackling the persistent ‘vaccine hesitancy’ that is fuelled by misinformation. UNICEF knows that every child benefits when all countries achieve and maintain high vaccine coverage across their entire territory. We work with governments, international agencies, non-governmental organizations and vaccine manufacturers to strengthen health systems and ensure supplies of life-saving vaccines for all children. We also aim to increase demand for immunization, educating the public on its importance, and equipping parents and communities with the knowledge they need to protect their children. Publication date November 2024 Languages English ### Files available for download [Report (pdf, 1 MB)](https://www.unicef.org/eca/media/37556/file/In%20Focus%20Immunization.pdf) ## Key facts ![In Focus Immunization](https://www.unicef.org/eca/sites/unicef.org.eca/files/styles/mc_three_hrz_desktop/public/47.webp?itok=H1XIyTG_) ![In Focus Immunization](https://www.unicef.org/eca/sites/unicef.org.eca/files/styles/mc_three_hrz_desktop/public/47.webp?itok=H1XIyTG_) ![In](https://www.unicef.org/eca/sites/unicef.org.eca/files/styles/lazy_load/public/47.webp?itok=5MYE0_Wp) ![In Focus Immunization](https://www.unicef.org/eca/sites/unicef.org.eca/files/styles/mc_three_hrz_desktop/public/48.webp?itok=hJwjmEbe) ![In Focus Immunization](https://www.unicef.org/eca/sites/unicef.org.eca/files/styles/mc_three_hrz_desktop/public/48.webp?itok=hJwjmEbe) ![In](https://www.unicef.org/eca/sites/unicef.org.eca/files/styles/lazy_load/public/48.webp?itok=riU4JWIv) ![In Focus Immunization](https://www.unicef.org/eca/sites/unicef.org.eca/files/styles/mc_three_hrz_desktop/public/49.webp?itok=reUZ6MYd) ![In Focus Immunization](https://www.unicef.org/eca/sites/unicef.org.eca/files/styles/mc_three_hrz_desktop/public/49.webp?itok=reUZ6MYd) ![In](https://www.unicef.org/eca/sites/unicef.org.eca/files/styles/lazy_load/public/49.webp?itok=bgw_8Q1a) ![In Focus Immunization](https://www.unicef.org/eca/sites/unicef.org.eca/files/styles/mc_three_hrz_desktop/public/50.webp?itok=ZhDdhrjM) ![In Focus Immunization](https://www.unicef.org/eca/sites/unicef.org.eca/files/styles/mc_three_hrz_desktop/public/50.webp?itok=ZhDdhrjM) ![In](https://www.unicef.org/eca/sites/unicef.org.eca/files/styles/lazy_load/public/50.webp?itok=hc1-tXI5) ![In Focus Immunization](https://www.unicef.org/eca/sites/unicef.org.eca/files/styles/mc_three_hrz_desktop/public/51.webp?itok=6E8a_Cd1) ![In Focus Immunization](https://www.unicef.org/eca/sites/unicef.org.eca/files/styles/mc_three_hrz_desktop/public/51.webp?itok=6E8a_Cd1) ![In](https://www.unicef.org/eca/sites/unicef.org.eca/files/styles/lazy_load/public/51.webp?itok=Yc-olfzv) ![In Focus Immunization](https://www.unicef.org/eca/sites/unicef.org.eca/files/styles/mc_three_hrz_desktop/public/52.webp?itok=Fy6RdcJ_) ![In Focus Immunization](https://www.unicef.org/eca/sites/unicef.org.eca/files/styles/mc_three_hrz_desktop/public/52.webp?itok=Fy6RdcJ_) ![In](https://www.unicef.org/eca/sites/unicef.org.eca/files/styles/lazy_load/public/52.webp?itok=lgCXooFt) Collection row media ![In Focus Immunization](https://www.unicef.org/eca/sites/unicef.org.eca/files/styles/mc_one_hrz_desktop/public/In%20focus%20Immunization_0.webp?itok=2uv39bX5) ![In Focus Immunization](https://www.unicef.org/eca/sites/unicef.org.eca/files/styles/mc_one_hrz_desktop/public/In%20focus%20Immunization_0.webp?itok=2uv39bX5) ![In](https://www.unicef.org/eca/sites/unicef.org.eca/files/styles/lazy_load/public/In%20focus%20Immunization_0.webp?itok=-xhkv0fk) ![Six-month-old Bilal is kissed on the cheek by his brother, Nurtilek, 17, after receiving his routine immunizations during a visit to a Family Medicine Centre in Bishkek, Kyrgyzstan. November 2022.](https://www.unicef.org/eca/sites/unicef.org.eca/files/styles/media_large_image/public/UN0760586.webp?itok=U1nzVzWl) ![Six-month-old Bilal is kissed on the cheek by his brother, Nurtilek, 17, after receiving his routine immunizations during a visit to a Family Medicine Centre in Bishkek, Kyrgyzstan. November 2022.](https://www.unicef.org/eca/sites/unicef.org.eca/files/styles/lazy_load/public/UN0760586.webp?itok=CMy_NCPY) UNICEF/UN0760586/Babajanyan VII Photo Six-month-old Bilal is kissed on the cheek by his brother, Nurtilek, 17, after receiving his routine immunizations during a visit to a Family Medicine Centre in Bishkek, Kyrgyzstan. November 2022. ## Key policy frameworks ![In Focus Immunization](https://www.unicef.org/eca/sites/unicef.org.eca/files/styles/media_large_image/public/In%20focus%20Immunization%201.webp?itok=rPgibAQ8) ![In Focus Immunization](https://www.unicef.org/eca/sites/unicef.org.eca/files/styles/lazy_load/public/In%20focus%20Immunization%201.webp?itok=uVHIdBjk) Convention on the Rights of the Child (1989) - Article 24: States Parties recognize the right of the child to the enjoyment of the highest attainable standard of health and to facilities for the treatment of illness and rehabilitation of health. States Parties shall strive to ensure that no child is deprived of his or her right of access to such health care services. Immunization Agenda 2030 (2020) This global strategy, endorsed by the World Health Assembly in 2020, aims for a world where everyone, everywhere, at every age, fully benefits from vaccines for good health and well-being. ![Three-month-old Fotima Burizoda smiles before getting vaccinated as part of her routine childhood immunization session at a health centre in Dushanbe, Tajikistan. She will receive the rotavirus vaccine, the pentavalent vaccine, and a vaccine against Polio – OPV, which will be her second polio vaccination. “Vaccines are very important for children. They prevent them from different diseases,” says Fotima’s mother, “I don’t have any concern. The first time we came here, she had a little fever, but it passed.” ](https://www.unicef.org/eca/sites/unicef.org.eca/files/styles/media_large_image/public/UN0635905%20%281%29.webp?itok=744PqkjT) ![Three-month-old Fotima Burizoda smiles before getting vaccinated as part of her routine childhood immunization session at a health centre in Dushanbe, Tajikistan. She will receive the rotavirus vaccine, the pentavalent vaccine, and a vaccine against Polio – OPV, which will be her second polio vaccination. “Vaccines are very important for children. They prevent them from different diseases,” says Fotima’s mother, “I don’t have any concern. The first time we came here, she had a little fever, but it passed.” ](https://www.unicef.org/eca/sites/unicef.org.eca/files/styles/lazy_load/public/UN0635905%20%281%29.webp?itok=NODInYh0) UNICEF/UN0635905/Babajanyan VII Photo Three-month-old Fotima Burizoda smiles before getting vaccinated as part of her routine childhood immunization session at a health centre in Dushanbe, Tajikistan. She will receive the rotavirus vaccine, the pentavalent vaccine, and a vaccine against Polio – OPV, which will be her second polio vaccination. “Vaccines are very important for children. They prevent them from different diseases,” says Fotima’s mother, “I don’t have any concern. The first time we came here, she had a little fever, but it passed.” March 2022. ## Challenges UNICEF has raised the alarm over a surge in measles cases, attributed to major backsliding in childhood immunization coverage. More than 1.8 million children in Europe and Central Asia have missed their measles vaccination over the past three years. The region now accounts for around half of the measles cases worldwide. There were more than 61,070 confirmed cases in the Europe and Central Asia region in 2023, up from just over 900 in 2022. And by September 2024, the European region had registered around 95,204 cases of measles, highlighting the insufficient response of the system to prevent the spread. Immunization coverage is crucial to control this crisis and safeguard the health of millions of children across the region. It is vital to address this urgent challenge, and improved immunization coverage is crucial to safeguard the health of millions of children across the region. The war in Ukraine is having a devastating impact on the health and well-being of its population. Mass displacement presents public health challenges both within Ukraine and in refugee-hosting communities and increases the risk of outbreaks of vaccine-preventable disease. Efforts to maintain Europe’s ‘polio free’ status, for example, now need to accelerate and intensify, backed by action to reinforce health systems in general, and immunization in particular. Immunization inequity continues to hamper efforts to reach the most vulnerable children with life-saving vaccines. Roma populations across the region, for example, have lower immunization coverage than non-Roma populations. According to findings from the UNICEF Multiple Indicator Cluster Surveys (MICS) conducted in Roma settlements, stark disparities between Roma and non-Roma communities reflect major challenges in accessing essential services, including basic healthcare and immunization. In Serbia, only 70 per cent of Roma children aged 18-29 months are fully immunized, compared to 89 per cent of non-Roma children. This inequity is also seen in Kosovo1, where only 42 per cent of Roma children aged 12-23 months have received all the basic antigens, in contrast to 90 per cent of non-Roma children. Such alarming discrepancies emphasize the urgent need for targeted interventions to address the substantial gaps in immunization access between different communities. They also reveal a diverse picture within countries across the region, with immunization coverage rates falling below 80 per cent in certain districts, far below safe levels. These gaps and disparities must be addressed to protect children against preventable but deadly diseases – a task that requires constant vigilance. The capacity of immunization programmes needs to expand in response to the emergence of new vaccines, which – while welcome – are adding to the complexity of immunization programming. These new vaccines are vital to provide an effective barrier to the transmission of vaccine-preventable diseases, such as pneumococcal disease and rotavirus, and to protect against cervical and other forms of cancers through, for example, vaccination against human papillomavirus. However, they entail a shift from the vaccination of infants alone to vaccinations across the course of life, including infancy, childhood and adolescence, and this is stretching the capacities of immunization programmes in many places. In addition, many countries in the region are classified as ‘middle-income’ and this has implications for their eligibility for official development assistance. There are concerns about the financial sustainability of their national immunization programmes, as increased national income does not guarantee that there is enough capacity for effective management. There are also concerns about ‘vaccine hesitancy’ – a growing mistrust or even refusal of immunization among some parents, fueled by myths and misinformation. Parents’ refusal to immunize their children may stem from negative media stories that falsely link child deaths or disabilities to vaccination. It may also be influenced by unfounded fears around vaccine safety spread by anti-vaccine movements, and exacerbated by a lack of clear and consistent information for parents about the importance of immunization and its minimal risks. 1 All references to Kosovo should be understood to be in the context of United Nations Security Council resolution 1244 (1999) ![In Focus Immunization](https://www.unicef.org/eca/sites/unicef.org.eca/files/styles/media_large_image/public/In%20focus%20Immunization%202.webp?itok=rZY_kOtV) ![In Focus Immunization](https://www.unicef.org/eca/sites/unicef.org.eca/files/styles/lazy_load/public/In%20focus%20Immunization%202.webp?itok=WvsGFOWE) ![A child at Polyclinic \#10 in Tbilisi, Georgia, undergoes routine immunization. April 2019.](https://www.unicef.org/eca/sites/unicef.org.eca/files/styles/media_large_image/public/UN0326765.webp?itok=WS5PqAkb) ![A child at Polyclinic \#10 in Tbilisi, Georgia, undergoes routine immunization. April 2019.](https://www.unicef.org/eca/sites/unicef.org.eca/files/styles/lazy_load/public/UN0326765.webp?itok=_lno2SCn) UNICEF/UN0326765 A child at Polyclinic \#10 in Tbilisi, Georgia, undergoes routine immunization. April 2019. ## UNICEF’s work for children UNICEF works with governments across Europe and Central Asia to invest in health systems that reach the most vulnerable children with life-saving immunizations, aiming to ensure that immunization is both universal and equitable. We know how to get the right vaccines to the right children at the right time, working with our partners to deploy new techniques and strategies to reach children in need and improve health systems. We support the provision of quality-assured vaccines, working with national governments, the World Health Organization, Gavi – the Vaccine Alliance, the Bill & Melinda Gates Foundation, the US and European Centers for Disease Control, and the Measles & Rubella Initiative (MRI), as well as non-governmental organizations, vaccine manufacturers and many others. We also mobilize funds and provide technical support to strengthen the development of evidence-based policies and increase the capacities of national immunization programmes, including budgeting for vaccine procurement and supply. UNICEF supports countries to introduce new vaccines, such as those for rotavirus, and the pneumococcal conjugate vaccine (PCV) and human papillomavirus vaccine (HPV) to protect children from a wider range of preventable diseases. We also help to strengthen the capacity of national and sub-national partners to create demand for immunization, aiming to address vaccine hesitancy, build public trust, tackle dangerous myths and combat misinformation. Our efforts include technical support for governments and partners on social-science research to gather data and other evidence. This is essential to build a greater understanding of the factors that influence vaccine hesitancy to inform communication strategies, capacity building plans for front-line health workers and community engagement. For example, we work closely with national and local authorities to reinforce the routine tracking of public perceptions and attitudes around immunization to address issues related to vaccine hesitancy and the spread of misinformation by anti-vaccine campaigners. ![Edgar receives his routine vaccinations at UNICEF-supported polyclinic \#1 in Vanadzor, Armenia. April 2021.](https://www.unicef.org/eca/sites/unicef.org.eca/files/styles/media_large_image/public/UN0452128.webp?itok=UxUpsWVV) ![Edgar receives his routine vaccinations at UNICEF-supported polyclinic \#1 in Vanadzor, Armenia. April 2021.](https://www.unicef.org/eca/sites/unicef.org.eca/files/styles/lazy_load/public/UN0452128.webp?itok=8n9uvxDK) UNICEF/UN0452128/Margaryan Edgar receives his routine vaccinations at UNICEF-supported polyclinic \#1 in Vanadzor, Armenia. April 2021. ## Protecting children from polio during war As the war in Ukraine continues, and people continue to flee from their homes, gaps in immunization coverage put children’s health at risk. UNICEF is working with its partners to keep vaccination going and maintain high routine coverage across the country, including the provision of catch-up vaccination for those children who have missed their scheduled vaccines. To go the last mile in polio eradication, UNICEF implements programmes that go beyond the traditional ‘two drops’ of polio vaccine, aiming to strengthen health systems and understand the behavioural and social drivers that shape public health. Not only are these crucial and life-saving investments, they are also vital for shared global health security. “Infectious diseases do not disappear during war,” says Yuliia Dovjanych, Head Doctor at the ‘Dbayu’ medical centre. “We must continue to get vaccinated, take care of our health and the health of our children.” In 2022, UNICEF procured more than 2 million doses of vaccines for Ukraine. In 2023, more than 650,000 doses of the polio vaccine and 657,000 doses of the combined measles-mumps-rubella vaccine were delivered, as well as almost 6.2 million syringes. UNICEF has also strengthened the cold chain, which ensures that vaccines are transported and stored at the right temperature, at all levels. - Through the COVAX initiative, UNICEF purchased 26 freezers to be installed at national and regional levels to strengthen the immunization chain. - Almost 5,200 vaccine refrigerators and freezers procured with World Bank funds will support safe vaccine storage at vaccination points. - UNICEF and USAID have also procured 36 refrigerator vans to transport vaccines from national centres to local (oblast) level and from there to vaccination points. - Vaccine carriers and cold boxes for vaccine storage and transportation have been provided for over 2,500 vaccination points and 800 mobile teams have been operating across Ukraine. Even in the most complex conflict settings, UNICEF and its partners know how to prevent catastrophic disease outbreak and are determined to make polio history. ![All vaccines at the health centre in Kyiv’s Shevchenkivskyi district, Ukraine, are stored in a specialized refrigerator provided by UNICEF. This keeps them at the optimal temperature of +2 to +8°C, even during power outages. May 2024.](https://www.unicef.org/eca/sites/unicef.org.eca/files/styles/media_large_image/public/In%20focus%20Immunization%203.webp?itok=BXaD5PM3) ![All vaccines at the health centre in Kyiv’s Shevchenkivskyi district, Ukraine, are stored in a specialized refrigerator provided by UNICEF. This keeps them at the optimal temperature of +2 to +8°C, even during power outages. May 2024.](https://www.unicef.org/eca/sites/unicef.org.eca/files/styles/lazy_load/public/In%20focus%20Immunization%203.webp?itok=0WOr1m-p) UNICEF/UNI601165/Vashkiv All vaccines at the health centre in Kyiv’s Shevchenkivskyi district, Ukraine, are stored in a specialized refrigerator provided by UNICEF. This keeps them at the optimal temperature of +2 to +8°C, even during power outages. May 2024. ## Uzbekistan: HPV vaccination across generations Nargiza received her first HPV vaccine shot at her school in Tashkent city, Uzbekistan, when she was 16. A doctor visited her school to tell the students that the vaccine would protect them from cancers and assured them of its safety. “I remember there were rumours that your fertility could be impacted, but I understood that the purpose of vaccines is to prevent disease,” Nargiza said. > “I had no doubts about receiving the shot.” Nargiza put her faith in scientific facts. After receiving her dose she had a mild headache – a common side effect and a small sacrifice for her peace of mind. Now aged 26 and still living in Tashkent, Nargiza is protecting her whole family against preventable illness through vaccines given to her children at the prescribed ages. While her daughters aged 2 and 4 aren’t old enough to have the HPV vaccine, they have had all their other vaccinations at the right time. Nargiza is creating a lasting tradition of vaccination in her family. She advocates that vaccines protect against preventable illnesses such as COVID-19, and against the human papillomavirus (HPV). While misinformation still abounds about vaccines and their side effects, she knows they exist only to protect people’s health and well-being. Yet the phenomenon known as ‘vaccine hesitancy’ persists. This fear of vaccines is founded on misinformation and dangerous myths, and UNICEF and its partners are fully committed to overcoming it. UNICEF is working with the World Health Organization and the Uzbekistan Ministry of Health to raise public awareness of vaccine-preventable diseases by, for example, sharing a range of information materials to help healthcare providers communicate with parents and caregivers and answer their frequently asked questions. TV shows, radio programmes and public service announcements on national and regional channels encourage parents to trust immunization services and protect children from preventable diseases. > “Vaccines train our bodies – train our immune systems – to be ready to fight illness. This is what I tell people who don’t want to get vaccinated. All people should vaccinate their children and themselves. It’s our best protection.” ![Alina, 9, sits with her mother at the Samarkand City Family Clinic. She has just received her first HPV vaccination administered by Vaccination Nurse Shoira Gafurova. Alina recently finished third grade. June 2022.](https://www.unicef.org/eca/sites/unicef.org.eca/files/styles/media_large_image/public/UN0687771%20%281%29.webp?itok=9uWyyQCX) ![Alina, 9, sits with her mother at the Samarkand City Family Clinic. She has just received her first HPV vaccination administered by Vaccination Nurse Shoira Gafurova. Alina recently finished third grade. June 2022.](https://www.unicef.org/eca/sites/unicef.org.eca/files/styles/lazy_load/public/UN0687771%20%281%29.webp?itok=iTAXVo31) UNICEF/UN0687771/Babajanyan VII Photo Alina, 9, sits with her mother at the Samarkand City Family Clinic. She has just received her first HPV vaccination administered by Vaccination Nurse Shoira Gafurova. Alina recently finished third grade. June 2022. ## Call to action Low vaccination rates and ongoing measles outbreaks in the region call for vigilance and greater efforts to improve universal routine immunization to protect children. Immunization strategies need to be tailored to reach all ‘zero dose’ and under-vaccinated children, including those in marginalized communities where the services are inadequate; those who may have become disconnected from services or are unreached by them; and those affected by conflict and insecurity. UNICEF is urging countries across the region to: - urgently identify and reach all children with immunization, especially those who have missed vaccinations - strengthen demand for vaccines, including by building confidence - prioritize funding to immunization services and primary health care - build resilient health systems through investment in health workers, innovation and local manufacturing to ensure robust local action that reaches everyone, everywhere with vaccines. One of UNICEF’s primary goals is to create an enabling environment for immunization and primary health care by 2030. This involves developing supportive policies, strengthening health systems, and fostering community engagement to lay a strong foundation for effective health services. Another critical objective is to enhance equitable access to quality immunization services. UNICEF aims to ensure that all individuals, particularly those who are the most vulnerable, can benefit from high-quality immunization services provided through resilient and well-supported primary health care systems. 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. 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 will continue to work with partners to strengthen routine immunization systems and step in whenever necessary to bolster immunization. The task ahead is to ensure fully sustainable, well-resourced and managed immunization systems that guarantee vaccinations for each and every child – with no exceptions. ![Dilbar (left), Chief Physician at the Samarkand City Family Clinic \#2, and Parvina, Patronage Nurse (second from left), walk with 11-year-old Leila and her mother Mukharram, visiting them at their home in Samarkand, Uzbekistan, on 29 June 2022. Leila recently finished fourth grade, and has just received her second dose of the HPV vaccine. April 2022.](https://www.unicef.org/eca/sites/unicef.org.eca/files/styles/media_large_image/public/UN0687706.webp?itok=ybj9-oyH) ![Dilbar (left), Chief Physician at the Samarkand City Family Clinic \#2, and Parvina, Patronage Nurse (second from left), walk with 11-year-old Leila and her mother Mukharram, visiting them at their home in Samarkand, Uzbekistan, on 29 June 2022. Leila recently finished fourth grade, and has just received her second dose of the HPV vaccine. April 2022.](https://www.unicef.org/eca/sites/unicef.org.eca/files/styles/lazy_load/public/UN0687706.webp?itok=n39fSU8q) UNICEF/UN0687706/Babajanyan VII Photo Dilbar (left), Chief Physician at the Samarkand City Family Clinic \#2, and Parvina, Patronage Nurse (second from left), walk with 11-year-old Leila and her mother Mukharram, visiting them at their home in Samarkand, Uzbekistan, on 29 June 2022. Leila recently finished fourth grade, and has just received her second dose of the HPV vaccine. April 2022. ## Related topics - [Health](https://www.unicef.org/eca/topics/health) - [Immunization](https://www.unicef.org/eca/topics/immunization) ## More to explore ![](https://www.unicef.org/eca/sites/unicef.org.eca/files/styles/large/public/UN0450955.webp?itok=Xd3uY1Ln) Press release 11 February 2026 ### [Measles cases dropped in Europe and Central Asia in 2025 compared to the previous year, but the risk of outbreaks remains – UNICEF and WHO](https://www.unicef.org/eca/press-releases/measles-cases-dropped-europe-and-central-asia-2025-compared-previous-year-risk "Measles cases dropped in Europe and Central Asia in 2025 compared to the previous year, but the risk of outbreaks remains – UNICEF and WHO") Read now ![](https://www.unicef.org/eca/sites/unicef.org.eca/files/styles/large/public/UNI730983.webp?itok=FObRz5_7) Article ### [Charting a healthier tomorrow for Europe's children](https://www.unicef.org/eca/stories/charting-healthier-tomorrow-europes-children-and-adolescents "Charting a healthier tomorrow for Europe's children") Despite Europe’s wealth, resources and high standards of living, the region’s children are being left behind - The Lancet Read now ![](https://www.unicef.org/eca/sites/unicef.org.eca/files/styles/large/public/UNI809830.webp?itok=F-wDjUTj) Press release 15 July 2025 ### [Childhood vaccination rates lag in Europe – fueling further resurgence of measles and whooping cough](https://www.unicef.org/eca/press-releases/childhood-vaccination-rates-lag-europe-fueling-further-resurgence-measles-and "Childhood vaccination rates lag in Europe – fueling further resurgence of measles and whooping cough") Read now ![](https://www.unicef.org/eca/sites/unicef.org.eca/files/styles/large/public/DSC02897%20%281%29.webp?itok=1zAFrQ9-) Press release 26 June 2025 ### [Chief Sanitary Inspectorate establishes the first Behavioural Science Team for Public Health in Poland](https://www.unicef.org/eca/press-releases/chief-sanitary-inspectorate-establishes-first-behavioural-science-team-public-health "Chief Sanitary Inspectorate establishes the first Behavioural Science Team for Public Health in Poland ") Read now ## [UNICEF Home](https://www.unicef.org/eca/ "UNICEF Home") - [What we do](https://www.unicef.org/eca/what-we-do "What we do") - [Situation for children](https://www.unicef.org/eca/situation-children-europe-and-central-asia "Situation for children") - [Where we work](https://www.unicef.org/eca/where-we-work "Where we work") ## [Data, Research and Reports](https://www.unicef.org/eca/research-and-reports "Data, Research and Reports") - [Publications](https://www.unicef.org/eca/research-and-reports/publications "Publications") - [Ambassadors and Supporters](https://www.unicef.org/eca/unicef-ambassadors-europe-and-central-asia "Ambassadors and Supporters") [Become a donor](https://help.unicef.org/) - [Visit us on Facebook](https://www.facebook.com/unicefeca) - [Visit us on Instagram](https://www.instagram.com/unicefecaro/) - [Visit us on LinkedIn](https://www.linkedin.com/company/unicefecaro) - [Visit us on TikTok](https://www.tiktok.com/@unicefeca) - [Visit us on Twitter](https://twitter.com/unicef_eca) - [Visit us on YouTube](https://www.youtube.com/@UNICEFECA) - [Contact us](https://www.unicef.org/eca/contact-us) - [Legal](https://www.unicef.org/legal) [Report fraud, abuse, wrongdoing](https://www.unicef.org/auditandinvestigation/report-wrongdoing) Cookie settings UNICEF strives to uphold the rights of every child, protecting them from harm and all forms of discrimination, so that they can grow up healthy and educated to reach their full potential. 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Readable Markdown	Flagship report Promoting and strengthening a life-saving investment UNICEF/UN0635915/Babajanyan VII Photo ### Highlights ### Immunization is one of the world’s most cost-effective public health interventions, preventing an estimated 4.4 million deaths each year, and protecting millions of children from preventable illness and disability. Yet, global childhood immunization coverage stalled in 2023, and the number of children worldwide who are under-vaccinated or not vaccinated at all has increased by 2.7 million since 2019, before the COVID-19 pandemic. In Europe and Central Asia, coverage of the first dose of the diphtheria-tetanus-pertussis (DTP1) vaccine in 2023 had recovered to its pre-pandemic level (2019) of 97 per cent. Coverage of the third dose (DTP3) – seen as the benchmark for the strength of routine immunization services – has also reached its pre-pandemic level, rising from 93 per cent in 2021 to 95 per cent. Yet 400,000 fewer children were vaccinated with DTP1 in the region in 2023 than in 2019, and 123,000 children remain completely unvaccinated. These ‘zero dose’ children remain vulnerable to, and unprotected from, measles, diphtheria and other life-threatening – but entirely preventable – diseases. There are also serious concerns about a surge in measles cases. A global strategy is in place – Immunization Agenda 2030 – to make vaccination available to everyone, everywhere, by the end of this decade. The challenge ahead is to fully reinvigorate immunization systems in the aftermath of the pandemic. This means closing the remaining coverage gaps within countries; ensuring effective immunization for the unprecedented numbers of children on the move across the region; and tackling the persistent ‘vaccine hesitancy’ that is fuelled by misinformation. UNICEF knows that every child benefits when all countries achieve and maintain high vaccine coverage across their entire territory. We work with governments, international agencies, non-governmental organizations and vaccine manufacturers to strengthen health systems and ensure supplies of life-saving vaccines for all children. We also aim to increase demand for immunization, educating the public on its importance, and equipping parents and communities with the knowledge they need to protect their children. Publication date November 2024 Languages English Key policy frameworks Convention on the Rights of the Child (1989) - Article 24: States Parties recognize the right of the child to the enjoyment of the highest attainable standard of health and to facilities for the treatment of illness and rehabilitation of health. States Parties shall strive to ensure that no child is deprived of his or her right of access to such health care services. Immunization Agenda 2030 (2020) This global strategy, endorsed by the World Health Assembly in 2020, aims for a world where everyone, everywhere, at every age, fully benefits from vaccines for good health and well-being. Challenges UNICEF has raised the alarm over a surge in measles cases, attributed to major backsliding in childhood immunization coverage. More than 1.8 million children in Europe and Central Asia have missed their measles vaccination over the past three years. The region now accounts for around half of the measles cases worldwide. There were more than 61,070 confirmed cases in the Europe and Central Asia region in 2023, up from just over 900 in 2022. And by September 2024, the European region had registered around 95,204 cases of measles, highlighting the insufficient response of the system to prevent the spread. Immunization coverage is crucial to control this crisis and safeguard the health of millions of children across the region. It is vital to address this urgent challenge, and improved immunization coverage is crucial to safeguard the health of millions of children across the region. The war in Ukraine is having a devastating impact on the health and well-being of its population. Mass displacement presents public health challenges both within Ukraine and in refugee-hosting communities and increases the risk of outbreaks of vaccine-preventable disease. Efforts to maintain Europe’s ‘polio free’ status, for example, now need to accelerate and intensify, backed by action to reinforce health systems in general, and immunization in particular. Immunization inequity continues to hamper efforts to reach the most vulnerable children with life-saving vaccines. Roma populations across the region, for example, have lower immunization coverage than non-Roma populations. According to findings from the UNICEF Multiple Indicator Cluster Surveys (MICS) conducted in Roma settlements, stark disparities between Roma and non-Roma communities reflect major challenges in accessing essential services, including basic healthcare and immunization. In Serbia, only 70 per cent of Roma children aged 18-29 months are fully immunized, compared to 89 per cent of non-Roma children. This inequity is also seen in Kosovo1, where only 42 per cent of Roma children aged 12-23 months have received all the basic antigens, in contrast to 90 per cent of non-Roma children. Such alarming discrepancies emphasize the urgent need for targeted interventions to address the substantial gaps in immunization access between different communities. They also reveal a diverse picture within countries across the region, with immunization coverage rates falling below 80 per cent in certain districts, far below safe levels. These gaps and disparities must be addressed to protect children against preventable but deadly diseases – a task that requires constant vigilance. The capacity of immunization programmes needs to expand in response to the emergence of new vaccines, which – while welcome – are adding to the complexity of immunization programming. These new vaccines are vital to provide an effective barrier to the transmission of vaccine-preventable diseases, such as pneumococcal disease and rotavirus, and to protect against cervical and other forms of cancers through, for example, vaccination against human papillomavirus. However, they entail a shift from the vaccination of infants alone to vaccinations across the course of life, including infancy, childhood and adolescence, and this is stretching the capacities of immunization programmes in many places. In addition, many countries in the region are classified as ‘middle-income’ and this has implications for their eligibility for official development assistance. There are concerns about the financial sustainability of their national immunization programmes, as increased national income does not guarantee that there is enough capacity for effective management. There are also concerns about ‘vaccine hesitancy’ – a growing mistrust or even refusal of immunization among some parents, fueled by myths and misinformation. Parents’ refusal to immunize their children may stem from negative media stories that falsely link child deaths or disabilities to vaccination. It may also be influenced by unfounded fears around vaccine safety spread by anti-vaccine movements, and exacerbated by a lack of clear and consistent information for parents about the importance of immunization and its minimal risks. 1 All references to Kosovo should be understood to be in the context of United Nations Security Council resolution 1244 (1999) UNICEF’s work for children UNICEF works with governments across Europe and Central Asia to invest in health systems that reach the most vulnerable children with life-saving immunizations, aiming to ensure that immunization is both universal and equitable. We know how to get the right vaccines to the right children at the right time, working with our partners to deploy new techniques and strategies to reach children in need and improve health systems. We support the provision of quality-assured vaccines, working with national governments, the World Health Organization, Gavi – the Vaccine Alliance, the Bill & Melinda Gates Foundation, the US and European Centers for Disease Control, and the Measles & Rubella Initiative (MRI), as well as non-governmental organizations, vaccine manufacturers and many others. We also mobilize funds and provide technical support to strengthen the development of evidence-based policies and increase the capacities of national immunization programmes, including budgeting for vaccine procurement and supply. UNICEF supports countries to introduce new vaccines, such as those for rotavirus, and the pneumococcal conjugate vaccine (PCV) and human papillomavirus vaccine (HPV) to protect children from a wider range of preventable diseases. We also help to strengthen the capacity of national and sub-national partners to create demand for immunization, aiming to address vaccine hesitancy, build public trust, tackle dangerous myths and combat misinformation. Our efforts include technical support for governments and partners on social-science research to gather data and other evidence. This is essential to build a greater understanding of the factors that influence vaccine hesitancy to inform communication strategies, capacity building plans for front-line health workers and community engagement. For example, we work closely with national and local authorities to reinforce the routine tracking of public perceptions and attitudes around immunization to address issues related to vaccine hesitancy and the spread of misinformation by anti-vaccine campaigners. Protecting children from polio during war As the war in Ukraine continues, and people continue to flee from their homes, gaps in immunization coverage put children’s health at risk. UNICEF is working with its partners to keep vaccination going and maintain high routine coverage across the country, including the provision of catch-up vaccination for those children who have missed their scheduled vaccines. To go the last mile in polio eradication, UNICEF implements programmes that go beyond the traditional ‘two drops’ of polio vaccine, aiming to strengthen health systems and understand the behavioural and social drivers that shape public health. Not only are these crucial and life-saving investments, they are also vital for shared global health security. “Infectious diseases do not disappear during war,” says Yuliia Dovjanych, Head Doctor at the ‘Dbayu’ medical centre. “We must continue to get vaccinated, take care of our health and the health of our children.” In 2022, UNICEF procured more than 2 million doses of vaccines for Ukraine. In 2023, more than 650,000 doses of the polio vaccine and 657,000 doses of the combined measles-mumps-rubella vaccine were delivered, as well as almost 6.2 million syringes. UNICEF has also strengthened the cold chain, which ensures that vaccines are transported and stored at the right temperature, at all levels. - Through the COVAX initiative, UNICEF purchased 26 freezers to be installed at national and regional levels to strengthen the immunization chain. - Almost 5,200 vaccine refrigerators and freezers procured with World Bank funds will support safe vaccine storage at vaccination points. - UNICEF and USAID have also procured 36 refrigerator vans to transport vaccines from national centres to local (oblast) level and from there to vaccination points. - Vaccine carriers and cold boxes for vaccine storage and transportation have been provided for over 2,500 vaccination points and 800 mobile teams have been operating across Ukraine. Even in the most complex conflict settings, UNICEF and its partners know how to prevent catastrophic disease outbreak and are determined to make polio history. Uzbekistan: HPV vaccination across generations Nargiza received her first HPV vaccine shot at her school in Tashkent city, Uzbekistan, when she was 16. A doctor visited her school to tell the students that the vaccine would protect them from cancers and assured them of its safety. “I remember there were rumours that your fertility could be impacted, but I understood that the purpose of vaccines is to prevent disease,” Nargiza said. > “I had no doubts about receiving the shot.” Nargiza put her faith in scientific facts. After receiving her dose she had a mild headache – a common side effect and a small sacrifice for her peace of mind. Now aged 26 and still living in Tashkent, Nargiza is protecting her whole family against preventable illness through vaccines given to her children at the prescribed ages. While her daughters aged 2 and 4 aren’t old enough to have the HPV vaccine, they have had all their other vaccinations at the right time. Nargiza is creating a lasting tradition of vaccination in her family. She advocates that vaccines protect against preventable illnesses such as COVID-19, and against the human papillomavirus (HPV). While misinformation still abounds about vaccines and their side effects, she knows they exist only to protect people’s health and well-being. Yet the phenomenon known as ‘vaccine hesitancy’ persists. This fear of vaccines is founded on misinformation and dangerous myths, and UNICEF and its partners are fully committed to overcoming it. UNICEF is working with the World Health Organization and the Uzbekistan Ministry of Health to raise public awareness of vaccine-preventable diseases by, for example, sharing a range of information materials to help healthcare providers communicate with parents and caregivers and answer their frequently asked questions. TV shows, radio programmes and public service announcements on national and regional channels encourage parents to trust immunization services and protect children from preventable diseases. > “Vaccines train our bodies – train our immune systems – to be ready to fight illness. This is what I tell people who don’t want to get vaccinated. All people should vaccinate their children and themselves. It’s our best protection.” Call to action Low vaccination rates and ongoing measles outbreaks in the region call for vigilance and greater efforts to improve universal routine immunization to protect children. Immunization strategies need to be tailored to reach all ‘zero dose’ and under-vaccinated children, including those in marginalized communities where the services are inadequate; those who may have become disconnected from services or are unreached by them; and those affected by conflict and insecurity. UNICEF is urging countries across the region to: - urgently identify and reach all children with immunization, especially those who have missed vaccinations - strengthen demand for vaccines, including by building confidence - prioritize funding to immunization services and primary health care - build resilient health systems through investment in health workers, innovation and local manufacturing to ensure robust local action that reaches everyone, everywhere with vaccines. One of UNICEF’s primary goals is to create an enabling environment for immunization and primary health care by 2030. This involves developing supportive policies, strengthening health systems, and fostering community engagement to lay a strong foundation for effective health services. Another critical objective is to enhance equitable access to quality immunization services. UNICEF aims to ensure that all individuals, particularly those who are the most vulnerable, can benefit from high-quality immunization services provided through resilient and well-supported primary health care systems. 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. 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 will continue to work with partners to strengthen routine immunization systems and step in whenever necessary to bolster immunization. The task ahead is to ensure fully sustainable, well-resourced and managed immunization systems that guarantee vaccinations for each and every child – with no exceptions.
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