South Korean flags, for article on catch-up vaccination

‘Major milestone’ immunization campaign begins in North Korea with support of UNICEF

For the first time since the COVID-19 pandemic gutted its immunization system, North Korea has launched a nationwide catch-up vaccination campaign — a major step toward protecting millions of children from preventable diseases. Backed by UNICEF, the effort began in September 2024 C.E. and aims to reach children and pregnant women across all 210 counties in the country.

At a glance

  • Vaccine doses delivered: Over four million doses — including Pentavalent, Measles-Rubella, Tetanus-Diphtheria, BCG, Hepatitis B, and Inactivated Poliovirus Vaccine — arrived in North Korea in July 2024 C.E. to launch the effort.
  • Immunization rates: Coverage collapsed from above 96% before the pandemic to below 42% by mid-2021 C.E., leaving vast numbers of children exposed to diseases like polio, diphtheria, and measles.
  • Health worker training: More than 7,200 health workers have been trained to manage the campaign and handle any adverse vaccine reactions safely.

Why this campaign matters

The scale of North Korea’s immunization collapse during the pandemic was severe. When the country shut its borders in early 2020 C.E., international health workers were locked out and supply chains broke down. By mid-2021 C.E., vaccination coverage had fallen by more than half — from a strong baseline to below 42%.

That gap left an entire generation of young children unprotected against diseases that routine vaccination had previously kept in check. Polio, diphtheria, measles, rubella, and hepatitis all became live threats again.

“This campaign is a major milestone in our drive to vaccinate every child in the DPRK and protect them from common childhood diseases,” said UNICEF’s Acting Representative for the country, Roland Kupka. “This is the first step in restoring routine immunization and closing the gap that has left children vulnerable to preventable diseases.”

Building the infrastructure back up

Of the four million doses delivered in July 2024 C.E., two million are being used in the current catch-up campaign. The remaining doses will be distributed to health centers nationwide to reinforce routine immunization going forward.

UNICEF also supplied new freezers, refrigerators, cold boxes, and temperature trackers to keep vaccines viable across even the most remote parts of the country. Maintaining cold chains in areas with limited infrastructure is one of the most persistent challenges in large-scale immunization programs worldwide.

The agency is overseeing vaccine delivery and administration, and tracking coverage data to measure the campaign’s reach. This kind of real-time monitoring helps identify gaps before they compound.

A foundation built over three difficult years

This is not the first attempt to close the gap. Between 2021 C.E. and 2023 C.E., UNICEF supported three previous catch-up campaigns in North Korea, reaching a combined total of nearly 1.3 million children who had missed essential vaccines during the pandemic’s peak. Each round laid groundwork for the current, more expansive effort.

The current campaign is the largest yet — the first to target all 210 counties simultaneously and to include pregnant women alongside children. That broadened reach reflects both growing organizational capacity and a more coordinated commitment from North Korea’s public health system.

Still, significant barriers remain. UNICEF international staff have not been permitted to return to the country since the border closures, limiting the agency’s ability to directly verify outcomes on the ground. Kupka urged the North Korean government to allow UN international staff back in: “To sustain progress in restoring pre-pandemic vaccination levels and ensuring every child receives essential, life-saving vaccines, we urge the DPRK government to swiftly allow the return of UNICEF and UN international staff in the country.”

Independent verification of coverage data — and the ability to respond quickly when problems arise — depends on that access being restored. Without it, even a well-resourced campaign operates with limited visibility.

What sustained success looks like

North Korea’s pre-pandemic immunization record was genuinely strong. Coverage above 96% put it in line with many high-income countries. Reaching that level again will require more than a single campaign — it demands the kind of routine, sustained delivery infrastructure that international health partnerships help support.

The four million doses now in-country, the trained health workers, and the cold-chain equipment are real foundations. The question is whether the political conditions will allow those foundations to hold — and grow — over time. For the children and families the vaccines are reaching now, the progress is immediate and real.

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For more on this story, see: UN Geneva

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