Image Credit: © UNICEF/UNI962604/Tiamiyu
A global initiative aimed at vaccinating millions of children who have missed essential immunizations has made significant strides, reaching over 18 million children in 36 countries. The Big Catch-Up, a multi-year campaign supported by UNICEF, Gavi, and the World Health Organization, concluded its implementation phase in March 2026, delivering more than 100 million vaccine doses. This effort primarily targeted low and lower-middle-income nations, especially across Africa and Asia, where health systems have faced considerable challenges.
The initiative specifically addressed the needs of zero-dose children, those who had never received any vaccinations, including critical vaccines for measles, polio, and diphtheria. The COVID-19 pandemic exacerbated the situation, halting routine immunization services and leading to a rise in the number of children missing vaccinations. The campaign was launched in response to the increase in zero-dose children, which had grown significantly during the pandemic.
Among the successes reported, Ethiopia managed to vaccinate over 2.5 million previously zero-dose children with their first doses of the diphtheria, tetanus, and pertussis vaccine. Nigeria also made notable progress, providing nearly two million first doses of the DTP vaccine alongside 3.4 million doses of the polio vaccine. The initiative is on track to meet its target of reaching at least 21 million children by the time final data is compiled.
Despite these achievements, challenges remain. Over 14 million infants continue to miss essential vaccines each year, and measles outbreaks have surged globally, with approximately 11 million cases reported in 2024. Experts emphasize the need for sustainable immunization systems to ensure that catch-up efforts do not become a recurring necessity. This involves building robust health infrastructures and restoring community trust in vaccination programs, particularly in conflict-affected regions.
The Big Catch-Up demonstrated the potential for effective vaccination campaigns even in challenging environments, with twelve participating countries achieving coverage for over 60% of zero-dose children under five. Moving forward, the focus will shift from temporary catch-up efforts to building resilient and sustainable vaccination systems to prevent future gaps in immunization.
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