Global childhood immunisation has stalled, with 14.3 million children receiving no vaccines at all in 2024, the World Health Organization and UNICEF said in their annual coverage report released on 15 July. The number of “zero-dose” children is unchanged from 2023 and remains four million above the benchmark needed to stay on track with the Immunisation Agenda 2030 goals. Overall coverage against diphtheria, tetanus and pertussis—widely used as a proxy for routine immunisation—held steady at 89% for a first dose and inched up to 85% for the full three-dose series. While one million additional children completed the series compared with 2023, nearly 20 million were either unvaccinated or only partly protected. Immunisation gaps are highly concentrated. Nine countries—Nigeria, India, Sudan, the Democratic Republic of Congo, Ethiopia, Indonesia, Yemen, Afghanistan and Angola—accounted for 52% of all zero-dose children. WHO said 55% of the 19.9 million un- or under-vaccinated children live in nations beset by conflict, fragility or other humanitarian crises. Funding shortfalls, geopolitical instability and vaccine misinformation are eroding past gains. Washington’s decision this year to withdraw financial support from WHO and halt pledged contributions to the vaccines alliance Gavi has deepened resource constraints. “Drastic cuts in aid, coupled with misinformation about the safety of vaccines, threaten to unwind decades of progress,” WHO Director-General Tedros Adhanom Ghebreyesus warned. Coverage against measles rose slightly, yet only 76% of children received the recommended second dose—far below the 95% threshold needed to prevent outbreaks. WHO recorded significant measles activity in 60 countries, with Europe alone reporting 125,000 cases in 2024, underscoring the risk posed by persistent vaccination gaps.