ABSTRACT
This report, which updates previous reports, presents estimates of global, regional, and national vaccination coverage and trends as of 2020. It describes the changes in vaccination coverage and the numbers of unvaccinated and undervaccinated children as measured by receipt of the first and third doses of diphtheria, tetanus, and pertussis-containing vaccine (DTP)in 2020, when the COVID-19 pandemic began, compared with 2019. Global coverage estimates with the third dose of DTP (DTP3) and a polio vaccine (Pol3) fell from 86% in 2019 to 83% in 2020. Similarly, MCV1 coverage fell from 86% in 2019 to 84% in 2020. The last year the coverage estimates were at 2020 levels was 2009 for DTP3 and 2014 for both MCV1 and the third dose of Pol (Pol3). Worldwide, 22.7 million children(17% of the target population) did not receive DTP in 2020, compared with 19.0 million (14%) in 2019. Children who did not receive the first DTP dose (DTP1) by age 12 months (zero-dose children) accounted for 95%of the increased number. Among those who did not receive DTP3 in 2020, approximately 17.1 million (75%)were zero-dose children. Global coverage decreased in 2020 compared with 2019 estimates for the completion of Haemophilus influenzae type b (Hib), hepatitis B vaccine (HepB), human papillomavirus vaccine (HPV),and rubella-containing vaccine (RCV). To reach full coverage with all recommended vaccines, tailored strategies will be needed, especially to reach communities with a lot of children who haven't had any or enough vaccines.