27 Jul Historic Milestone: 71% of World’s Children Protected Against Pneumococcal Disease
Statement by the Secure PCV Collaborators in response to the WHO/UNICEF Estimates of National Immunization Coverage (WUENIC)
More than seven in every ten infants are protected with three doses of the pneumococcal conjugate vaccine (PCV) in 2025, according to the latest vaccine coverage estimates from the World Health Organization (WHO) and UNICEF – a major milestone in the long journey to protect children from the deadliest pathogen – Streptococcus pneumoniae.
Each year, an estimated 674,000 people die from Streptococcus pneumoniae, including 211,000 children under five, mostly from pneumonia but also from meningitis. Streptococcus pneumoniae kills more children than any other single pathogen,according to the Global Burden of Disease.
One of the reasons deaths remain so high is the relatively low coverage of PCV, which has lagged other vaccines including Diphtheria, Tetanus, and Pertussis (DTP, Haemophilus influenzae type b (Hib), and measles. The increase in PCV coverage from 69% in 2024 to 71% in 2025 is a welcome signal that countries are making progress in protecting their children from pneumonia.
However, despite this improvement, wide regional and national disparities in PCV coverage remain. For example, more than 80% of children in Europe, the Americas, and South-east Asia are protected with three doses of PCV, compared with 70% of infants in Africa, 61% in the Eastern Mediterranean, and just 34% in the Western Pacific regions.
Among low- and middle-income countries (LMICs), 23 still do not offer the PCV at all, including countries with large burdens of childhood pneumonia like China, Egypt, Guinea, Thailand, and Viet Nam. Six of the “no-PCV” countries are eligible for financial support from Gavi, the Vaccine Alliance, including Comoros, Guinea, North Korea, Syria, and Venezuela (1).
There are a further 19 countries with PCV coverage rates below 60%, including 10 which are Gavi-eligible. Of note among the “low-PCV” group are three countries that introduced PCV in 2024, including Chad, Somalia, and South Sudan. These countries – all fragile and conflict-affected – should be applauded for making such progress in very challenging times (2).
The largest group of countries are the 53 with PCV coverage rates between 60% and 90% (3). Among these there are impressive coverage increases in Cameroon, Congo, Ethiopia, Liberia, Mali, Niger, Indonesia, Samoa, Tajikistan, Timor Leste, and Vanuatu.
Of great concern, there are countries where PCV coverage rates have gone alarmingly backwards, dropping by more than five percentage points since 2021, including in several African countries. For example, in South Africa, PCV coverage has fallen by 22 percentage points in five years.
Thirty-six countries have met the 90% PCV coverage target, including 16 for the first time. This includes several whose PCV coverage performance has been stunning. For example, India has increased PCV coverage to 97% coverage in just seven years, Turkmenistan to 98% in five years, and the Cook Islands to 99% in just three years (4).
Despite the challenging health financing environment, countries have new opportunities to drive further coverage increases. For Gavi countries, a new, low $US1.55 per dose (multidose vial) PCV is now available from the Serum Institute of India (down from $2.00 per dose).
And for countries with 80% or above PCV coverage and single-dose measles vaccine coverage over the last five years, there is another option, endorsed by WHO, to reduce the number of PCV doses from three to two. This could save up to one-third of the PCV vaccine budget without compromising health impact.
So far only one country has made the switch – the United Kingdom – and Fiji has announced it will do so later this year. Of the 50 low- and middle-income countries (LMICs) that meet the WHO criteria for the switch to PCV 1+1, 22 are Gavi-eligible (5).
Countries making the switch could further benefit by reallocating the savings to introduce other vaccines, including the maternal vaccine that protects against Respiratory Syncytial Virus (RSV), a major cause of viral pneumonia and hospitalization among children. To date, Argentina and Brazil are the only LMICs to have introduced the RSV maternal vaccine, and results showing reductions in RSV hospital admissions are extremely promising.
There is now an unrivaled opportunity for countries to prevent pneumonia among children without significantly increasing their vaccine budgets. Driving and sustaining PCV coverage above 80%, switching to a 1+1 schedule, and reallocating the savings to introduce RSV maternal vaccines has the potential to dramatically reduce deaths from pneumonia and hospital budgets.
July 2026
For more information on the Secure PCV Collaborators – https://stoppneumonia.org/latest/secure-pcv/
(1) “No-PCV” LMICs (*Gavi-eligible) – Bosnia and Herzegovina, Cabo Verde, China, Dominica, Egypt, Equatorial Guinea, Gabon, Grenada, Jamaica, Jordan, Saint Kitts and Nevis, Saint Vincent and the Grenadines, Saint Lucia, Sri Lanka, Suriname, Thailand, Ukraine, Viet Nam, *Comoros, *North Korea, *Guinea, *Syria, and *Venezuela.
(2) “Low-PCV” (<60%) LMICs (*Gavi-eligible) – Azerbaijan, 52%, Belarus, 16%, Bolivia, 59%, Iran, 54%, Kazakhstan, 49%, Maldives, 2% (introduced 2024), Montenegro, 28% (introduced 2024), North Macedonia, 60%, Philippines, 59%, *Angola, 54%, *Central African Republic, 45%, *Chad, 49% (introduced 2024), *Cote d’Ivoire, 59%, *Haiti, 39%, *Madagascar, 56%, *Papua New Guinea, 44%, *Somalia, 20% (introduced 2024), *South Sudan, 27% (introduced 2024), and *Yemen, 39%.
(3) “Medium-PCV” (60-90%) LMICs (*Gavi-eligible) – Albania, 81%, Argentina, 79%, Belize, 75%, Brazil, 88%, Colombia, 89%, Dominican Republic, 87%, Ecuador, 76%, Guatemala, 85%, Honduras, 86%, Indonesia, 69%, Iraq 82%, Kiribati 87%, Lebanon, 67%, Marshall Islands, 62%, Mexico, 78%, Micronesia, 69%, Morocco, 77%, Namibia, 83%, Peru, 80%, Moldova, 77%, Samoa, 89%, South Africa, 65%, and Vanuatu, 76%, *Afghanistan, 63%, *Benin, 64%, *Burundi, 88%, *Cambodia, 80%, *Cameroon, 82%, *Congo, 85%, *Democratic Republic of Congo, 63%, *Djibouti, 82%, *Ethiopia, 81%, *Gambia, 82%, *Kenya, 87%, *Kyrgyzstan, 84%, *Lao, 62%, *Lesotho, 88%, *Liberia, 80%, *Mali, 81%, *Mauritania, 85%, *Mozambique, 70%, *Myanmar, 71%, *Niger, 87%, *Nigeria, 62%, *Pakistan, 86%, *São Tomé and Príncipe, 86%, *Solomon Islands, 88%, *Sudan, 74%, *Tajikistan, 79%, *Timor Leste, 82%, *Togo, 89%, *Tanzania, 82%, and *Zambia, 88%.
(4) Mission accomplished >90 (*Gavi-eligible) – Algeria, 95%, Armenia, 96%, Bhutan, 99%, Botswana, 95%, Cook Islands, 99%, Cuba, 99% (just introduced), El Salvador, 98%, Fiji, 92%, Guyana, 99%, India, 97%, Libya, 92%, Malawi, 91%, Malaysia, 93%, Mauritius, 94.8%, Mongolia, 96%, Nepal, 94%, Nicaragua, 96%, Niue, 95%, Palestine, 99%, Paraguay, 91%, Serbia, 91%, Tonga, 94%, Tunisia, 96%, Turkmenistan, 98%, Tuvalu, 97%, Türkiye, 92%, Uzbekistan, 99%, *Bangladesh, 94%, *Burkina Faso, 91%, *Eritrea, 96%, *Ghana, 97%, *Guinea Bissau, 90%, *Rwanda, 96%, *Senegal, 91%, *Sierra Leone, 93%, *Uganda, 97%, and *Zimbabwe, 91%.
(5) Gavi-countries eligible for PCV 1+1 (average % PCV coverage/average measles vaccine coverage 2021-25) – Bangladesh (96.4/95), Burkina Faso (86/88), Burundi (89.8/87.4), Cambodia (83/83.4), Eritrea (05.2/93), Ghana (97.2/93), Kenya (90.8/84), Kyrgyzstan (88.6/93.2), Lesotho (90.4/84), Malawi (90.8/87.2), Mauritania (84.4/87.4), Nepal (89/93.2), Pakistan (85.4/83.4), Rwanda ()94.6/94.4, São Tomé and Príncipe (89.4/84), Senegal (89.8/88.2), Sierra Leone (92.4/89.4), Tanzania (83.4/83.2), Togo (89.4/80.6), Uganda (92.6/91.2), Zambia (84.8/89.4), and Zimbabwe (90/89.6).