The news that a third child has died from Pertussis in the US was a gut punch for folks who care about public health. It came on top of the news that the Measles outbreak that started in Florida last year has spread across much of the US. We are now approaching 2000 confirmed cases of the disease from which three American have died.
I visited Belize recently. For those who are unaware, Belize is a developing nation in Central America sandwiched between Mexico, Guatamala and Hondouras. Belize lacks the infrastructure we have in the US but they have not had a single death from Measles or Pertussis in 2025. While children, in the US are dying of Measles and Pertussis, mostly roadless Belize has not had a single death from these preventable diseases. Vaccination is free, available and encouraged in the country.
That observation prompted the following question. Where does the US rank among other nations for childhood vaccination rate?
Here is a clear global overview of how nations rank in childhood immunization rates, based on the standard WHO/UNICEF Estimates of National Immunization Coverage (WUENIC) — the world’s gold-standard dataset.
🌍 How Nations Rank in Childhood Immunization Rates
1️⃣ Best-Performing Countries (High Income & Some Middle Income)
These countries consistently achieve 95–99% coverage for nearly all routine childhood vaccines (DTP3, Polio3, MMR1/2, HepB, Hib, PCV, etc.).
Top-Tier (95–99% coverage across most vaccines)
Portugal
Hungary
China
Cuba
Rwanda (among the top globally despite being low-income)
Bangladesh
Sri Lanka
South Korea
Japan
Spain
Denmark
Sweden
Netherlands
United Kingdom
United Arab Emirates
Saudi Arabia
Why they rank high:
Strong public-health systems, national vaccination schedules, high trust in healthcare, low vaccine refusal.
2️⃣ Middle-Performing Countries (80–94% coverage)
Most countries fall here.
Examples
United States
(DTP3 ~92%, MMR ~91% nationally, with pockets of lower coverage)Belize
(generally 90–94% depending on vaccine and year)Mexico
Brazil
Argentina
Costa Rica
Colombia
Vietnam
Thailand
Turkey
Australia
Canada
Germany
France
Why mid-tier:
Generally strong programs but impacted by regional disparities, vaccine hesitancy, or logistical gaps.
3️⃣ Lower-Performing Countries (50–79% coverage)
Mostly low- and lower-middle-income regions, plus conflict-affected areas.
Examples
India (improving rapidly; varies by state)
Pakistan
Philippines
Indonesia
South Africa
Nigeria
Ethiopia
Chad
Sudan
Somalia
Reasons:
Supply-chain challenges, conflict, rural access issues, fluctuating funding, hesitancy.
4️⃣ Lowest-Performing (<50% coverage)
These tend to have severe instability, lack of infrastructure, or major humanitarian crises.
Examples
Yemen
South Sudan
Central African Republic
Afghanistan (varies by region)
Syria (war-affected regions)
The USA is not a top performing nation with respect to childhood vaccination rates, not even close. Cuba, Rawanda, Bangladesh and Sri Lanka among others rank above the US. There are no reports on children dying of Measles or Pertussis there.
Trump, Kennedy and the antivax movement are dragging the US down the drain with respect to childhood vaccination rates and that is the reason why American children are dying from vaccine preventable diseases. American children deserve better.
