• Health agencies, political institutions, global and regional funders, and immunization partners have noted insufficient immunization system improvements among middleincome countries (MICs) ineligible for Gavi support.
  • A large population of children reside in Gavi-unsupported MICs, where 68 million infants are born each year, making up 51% of the world’s infants.
  • Vaccine coverage declined more in non-Gavi MICs than in other country groupings during the pandemic, with coverage for certain vaccines, like HPVc, dropping precipitously.
  • Further, 8.2 million of the 18 million “zero dose” children who never received any vaccines in 2021 (45% of all zero-dose children) live in non-Gavi-MICs.
  • This brief highlights data from a selection of the Immunization Agenda 2030 Impact Goals, adapted from the Immunization Agenda 2030 (IA2030) scorecard.
  • As a follow up to two other formative MICs-related white papers from 2015 and 2020, this brief seeks to highlight global performance trends and the need for coordinated actions to improve vaccine access in MICs.