Immunization

Our goal
To urgently reach children, adolescents, and adults in lower-income countries with the vaccines they need, and help create a world free of vaccine-preventable diseases.
Lawrence Turere, 5 months, with his mother Elisabeth Turere receives a routine immunization from doctor Douglas Momanyi at Iloodariak  Dispensary in the County of Kajiado, Kenya on May 15, 2019.
Lawrence, with his mother Elisabeth Turere, receives a routine immunization from Dr. Douglas Momanyi at Iloodariak Dispensary in Kajiado County, Kenya. ©Gates Archive/Dominique Catton

At a glance

  • Vaccines are one of the world’s most cost-effective health tools, saving 3.5 to 5 million lives each year.
  • Countries around the globe have made impressive strides in combating vaccine-preventable diseases—including eradicating smallpox and dramatically reducing the number of people falling ill or dying from diseases such as polio, pneumonia, rotavirus, and measles.
  • In recent years, progress has stalled as routine immunization programs and basic health care services faced major disruptions, resulting in significant decreases in immunization coverage rates, which have not fully recovered. In 2023, 14.5 million children did not receive a single vaccine, compared with 13.9 million the previous year.
  • We support the delivery of lifesaving vaccines to places with some of the highest rates of unimmunized children.
  • As part of Gavi, the Vaccine Alliance, our team works with country governments, the World Health Organization (WHO), UNICEF, the World Bank, and a wide range of national, local, and global partners to provide new and underused vaccines to millions of people in lower-income countries.

The latest updates on immunization

Our strategy

Our strategy

The Immunization team works to bring new perspectives to immunization challenges and fund solutions that improve the delivery of high-quality and affordable vaccines—including the pentavalent vaccine, the hexavalent vaccine, pneumococcal conjugate vaccines, inactivated polio vaccine, oral cholera vaccine, and vaccines against rotavirus, human papillomavirus (HPV), measles, and meningitis A. We focus on making immunization more accessible by strengthening vaccine delivery in lower-income countries to reach the most vulnerable children, as well as adolescents and adults.

We partner with countries, multilateral organizations, the private sector, and civil society organizations to support vaccine introductions and improve access at the national level to reach immunization goals in the most underserved communities. We particularly focus on high-impact efforts, including HPV vaccine introductions and measles campaigns.

We believe that robust and resilient immunization programs are the cornerstone of strong primary health care systems. Our work contributes to the Immunization Agenda 2030—a global vision to extend the full benefits of immunization to all by 2030—and aligns with Gavi’s 6.0 strategy, which plays a key role in expanding equitable access to vaccines through the end of the decade.

Sabitas' child receives a pneumococcal conjugate vaccine (PCV) from an Auxiliary Nurse Midwife (ANM) Worker. The PCV gives protection against 13 types of pneumococcal bacteria that all cause pneumococcal disease at an Anganwadi Centre (AWC) in Bhopal, Madhya Pradesh, India on September 26, 2018.
Sabitas' child receives a pneumococcal conjugate vaccine from an Auxiliary Nurse Midwife Worker at an Anganwadi Centre in Bhopal, Madhya Pradesh, India. ©Gates Archive/Mansi Midha
Areas of focus

Areas of focus

We work with local, national, and global partners to ensure that vaccines are affordable and vaccine delivery aligns with local demand, especially in areas with the lowest immunization coverage. As part of Gavi, our foundation works with WHO, UNICEF, the World Bank and others to support vaccine introductions and scale up efforts, as well as health systems strengthening.

We help make high-quality and affordable vaccines available by ensuring that supply meets demand, procurement is effective and efficient, and supply chains deliver vaccines when and where they are needed. We focus on using data to inform strong decision-making and accountability and to identify gaps in the partner ecosystem that can be filled through our financial support and expertise.

We work to accelerate the introduction, use, and optimization of high-impact Gavi-supported vaccines to save lives, with particular focus on HPV vaccine introductions and measles campaigns.

In collaboration with governments and local, national, and global partners, we work to strengthen immunization systems and delivery pathways to reach underserved communities. We focus on addressing health system constraints and barriers to care, including by bolstering coverage in under-immunized communities.

We support Gavi as the primary channel for funding vaccines in lower-income countries. In addition, we work to strengthen a broader ecosystem of partners—at the global, regional, and country levels—to help Gavi fulfill its mission of ensuring equitable access to lifesaving vaccines.

Through RISP, we work to improve routine immunization coverage in subnational areas that have some of the lowest rates of vaccine coverage. Our work has a rigorous focus on rapid learning, impact measurement, and building strong partnerships. We apply lessons to the broader immunization sector’s understanding of replicable and sustainable approaches to improving immunization coverage in conflict zones and fragile and low-coverage settings.

We work closely with country leaders, development partners, civil society organizations, WHO, UNICEF, the World Bank and other partners on advocacy and communications efforts to ensure that immunization remains a priority at the global, regional, and national levels. This work includes mobilizing funding for Gavi, supporting advocates and immunization champions in raising awareness of the importance of restoring and strengthening routine immunization, and ensuring that sufficient funding and strong policies are in place to support vaccine introductions and scaling up of immunization efforts.

Why focus on immunization?

Why focus on immunization ?

In 1997, after reading a newspaper article about the millions of children dying of preventable diseases in lower-income countries each year, Bill Gates and Melinda French Gates were driven to act, laying the groundwork for the foundation’s immunization work.

Vaccines are safe, effective, and save millions of lives each year. They are one of the best tools for keeping children healthy and protected from deadly and debilitating diseases. Since WHO launched the Expanded Programme on Immunization in 1974, vaccines have saved the lives of an estimated 154 million people, the vast majority of them children—equal to six lives saved every minute. Measles vaccination alone accounts for nearly 94 million of the lives saved. Immunization has also been the most powerful tool for improving infant survival, reducing infant deaths by 40% globally—and by 52% in Africa—during that same period.

Over these decades, vaccines have been responsible for eradicating smallpox and dramatically reducing the number of people falling ill or dying from diseases such as polio, pneumonia, rotavirus, and measles. Our foundation has helped to accelerate the development and introduction of many new vaccines—including vaccines against polio, pneumococcal pneumonia, rotavirus, measles, meningitis A, cholera, and HPV—that have saved or improved the lives of hundreds of millions of people.

Access to vaccines has positive ripple effects for children, their families, and entire communities. Vaccines keep children safe from diseases that can hold them back from school and limit their physical and mental development. By keeping them healthy, vaccines help children reach their full potential. If we increase vaccine coverage in lower-income countries by 2030, we could prevent millions of people from falling into poverty due to health expenses.

Our largest grantee is Gavi, which has successfully accelerated vaccine introductions and improved immunization coverage in lower-income countries. From 2000 to 2023, Gavi and its partners have immunized over 1.1 billion children, preventing more than 18.8 million future deaths.

Dawai poses for a photo with his mom Poline during a door to door polio vaccine campaign in Adia, Cameroon on March 3, 2018.
Dawai poses for a photo with his mom Poline during a door to door polio vaccine campaign in Adia, Cameroon. ©Gates Archive/Dominique Catton

But progress has stalled in recent years as routine immunization programs and basic health care services faced major disruptions, resulting in significant decreases in immunization coverage rates, which have not fully recovered. In 2023, 14.5 million children did not receive a single vaccine, compared with 13.9 million the previous year. While some regions of the world have seen vaccination rates start to recover, millions of children remain unprotected against deadly diseases. Measles cases increased by 20% in 2023 compared to 2022, with 61 countries experiencing large or disruptive measles outbreaks, all attributed to low vaccination coverage rates.

These concerning trends are leaving millions of children vulnerable to vaccine-preventable diseases and putting decades of immunization progress at risk. Now is the time to urgently address stagnating immunization rates and the resurgence of vaccine-preventable disease outbreaks around the world. This is particularly important in lower-income countries that bear the highest burden of vaccine-preventable deaths.

Strategy leadership

Strategy leadership