Childhood Immunization Coverage in Africa: Progress and Disparities

Strategic Insights -

In the last two decades, childhood immunization coverage has improved significantly across most African countries, with overall coverage rates increasing between 2000 and 2019. However, a new study published in PLOS Medicine warns that 12 countries are unlikely to meet global targets for full immunization by 2030. The study, led by Phuong The Nguyen of Hitotsubashi University, Japan, and colleagues, highlights the importance of monitoring and progress in childhood immunizations at the national and local level to achieve global targets.

Key Takeaways:

  • The study used childhood immunization data from approximately 1 million records from 104 nationally representative Demographic and Health Surveys (DHS) conducted in 38 African countries between 2000 and 2019.
  • Overall improvements in immunization coverage were observed between 2000 and 2019, with most countries projected to meet or exceed targets for achieving 80% or 90% coverage of vaccines against tuberculosis, measles, polio, diphtheria, pertussis, and tetanus by 2030.
  • However, 12 of 38 countries, including high-development nations like South Africa, Egypt, and Congo Brazzaville, are not on track to meet full immunization goals.
  • Significant socioeconomic inequalities in coverage were present, with gaps in coverage of up to 58% between wealth quintiles.
  • Disparities were also observed across geographic regions, with most countries projected to shrink these gaps by 2030, except in Nigeria and Angola, where inequalities are expected to persist or grow.
  • The study emphasizes the importance of reliable sub-national data for identifying communities being left behind and informs more equitable and targeted immunization strategies.

Statistics:

  • Approximately 1 million records from 104 nationally representative Demographic and Health Surveys (DHS) were used in the analysis.
  • Overall improvements in immunization coverage were observed between 2000 and 2019, with a projected 80% or 90% coverage of vaccines against tuberculosis, measles, polio, diphtheria, pertussis, and tetanus in most countries by 2030.
  • 12 out of 38 countries are not on track to meet full immunization goals by 2030.
  • Significant socioeconomic inequalities in coverage were present, with gaps in coverage of up to 58% between wealth quintiles.
  • The study suggests that conducting this analysis reinforced the importance of reliable sub-national data for identifying communities being left behind.

Sources:

  • PLOS Medicine: "Progress and inequality in child immunization in 38 African countries, 2000-2030: A spatio-temporal Bayesian analysis at national and sub-national levels" by Nguyen PT, Nakamura R, Shimadzu H, Abubakar AK, Le PM, Nguyen HV, et al. (2025)
  • Japan Society for the Promotion of Science (Grant Numbers 22J13600 and 22KJ2761 to PN; Grant Number 23H00049 to MS, RN, and PN)