This site uses cookies to collect activity data and personalize content. By continuing to navigate this site, you agree to allow us to collect information using cookies. Learn more about how we care for your data in our privacy notice.

Worldwide, more than 17 million children went unvaccinated in 2020. As Gavi and others work to close gaps in vaccine access, here’s how PATH can help.

Health workers in rural Malawi delivering vaccines—doses kept cold in a PATH-designed vaccine carrier. Photo: PATH.

Making progress toward health equity requires a granular understanding of where there are gaps in access or uptake, why those gaps exist, and what can be done to address them. Though vaccination represents only one pillar or part of the primary health care system, it is an especially important one for protecting the health of children.

According to WHO/UNICEF estimates, in 2020, more than 17 million children worldwide were unvaccinated or zero-dose: defined as not receiving the first dose of diphtheria-tetanus-pertussis vaccine (DTP1). According to those same estimates, another 6 million children were under-vaccinated (did not receive the third dose, DTP3).

“In general, it would be fair to see zero-dose and under-immunized children as indicators of gaps in the immunization system and health care inequity,” says Deborah Atherly, PhD, BScPharm, Global Head of Policy, Access, and Introduction at PATH’s Center for Vaccine Innovation and Access. “Ultimately, what we do to reach those children should also contribute to strengthening of the primary health care system as part of a country’s universal health coverage goals.” 

Among the estimated 17 million zero-dose children, about half (8.8 million) live in 12 countries—Afghanistan, Ethiopia, India, Kenya, Nigeria, Madagascar, Mali, Pakistan, Somalia, South Sudan, Uganda, and Zambia. These countries encompass a diversity of settings with anticipated variability in the drivers of zero-dose and under-immunized children, which are complex, interrelated, and highly contextualized. 

Reaching zero-dose children and missed communities—defined by higher rates of zero-dose and under-vaccinated children—will require tailored approaches that address multiple and intersecting sociocultural barriers and economic vulnerabilities, as well as health system challenges to delivering immunization services through the primary health care system and WHO’s Expanded Program on Immunization.

PATH leverages it extensive experience strengthening immunization systems and introducing vaccines as a core partner in the USAID-funded MOMENTUM—Routine Immunization Transformation and Equity, a global consortium that aims to reduce the number of zero-dose children.

MOMENTUM Routine Immunization Transformation and Equity and its members work with national and local health systems to diagnose obstacles to equitable coverage and respond in a variety of ways, depending on the needs, including:

For example, MOMENTUM Routine Immunization Transformation and Equity has been working in the Democratic Republic of the Congo and Mozambique to understand the unique barriers faced by families of zero-dose children. Using a human-centered design approach, we engaged community members and clients in solution development. By centering the experiences of the communities we seek to support, these workshops helped the project, local communities, and immunization partners to develop tailored strategies for reaching zero-dose children and their families.

At PATH, we’re proud to be a part of the MOMENTUM global partnership and to do our part to realize a world where all people receive high-quality vaccination services to protect their children and themselves against vaccine-preventable diseases.

PATH leverages decades of hands-on experience developing, introducing, and improving vaccines and immunization technologies to advance and sustain country goals for immunization equity and vaccine coverage and global goals outlined by multilaterals like Gavi, WHO, and UNICEF.

Over the years, we’ve helped advance vaccine access in many different ways: helping decision-makers determine the best use of limited resources with cost-effectiveness and return-on-investment assessments before and after vaccine introduction; supporting the development and rollout of digital systems to help manage routine immunizations, better direct resources to underserved areas, and deliver more targeted patient care; facilitating knowledge sharing between countries and health departments to speed the digital transformation of entire regions; and more.

PATH’s relevant capacities fall into four functions or areas:

By submitting this form, you are agreeing to the data-use policies outlined in this privacy notice.