In the south Asian region, the countries with the highest number of zero-dose children in 2023 after India were Pakistan (419,000), Nepal (11,000), and Bangladesh (6,000).

The paper also has new projections through 2030 on global childhood vaccine coverage that shows that the world will fail to meet the World Health Organisation’s (WHO) immunisation goals unless substantial improvements are made in the next five years.

“The world has made unprecedented progress in vaccinating children against life-threatening disease since WHO established the Expanded Programme on Immunisation (EPI) in 1974. Despite the progress of the past 50 years, the last two decades have also been marked by stagnating childhood vaccination rates and wide variation in vaccine coverage. These challenges have been further exacerbated by the COVID-19 pandemic, leaving millions of children vulnerable to preventable diseases and death…,” read the paper.

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While India has been ranked as the country with the second highest number of zero-dose children, the comparison is somewhat flawed. As the ministry of health and family welfare, government of India, has been maintaining that India’s vaccination coverage among children has been growing steadily but owing to the country’s large population, their comparison with most other countries cannot be without error.

Last year, officials aware of the matter in the government, responded to vaccination coverage estimates released by WHO and United Nations Children’s Fund (UNICEF) that showed at 1.6 million India had the second highest zero-dose children in the world after Nigeria with 2.1 million unvaccinated children. The officials said that the estimates were flawed as the country’s base population had not been taken into consideration while calculating the numbers and if the population had been considered then the percentage would be much less.

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It is a valid argument as any numbers coming from India— without considering its baseline population— would seem through the roof. The estimation has to grow more nuanced.