Routine DTP Vaccination Coverage and Herd Immunity Against Pertussis in 2024 Did Not Recover to Pre-COVID-19 Levels Globally and in WHO Regions

<b>Objectives</b>: The study's objective was to assess ten diphtheria-tetanus-pertussis (DTP) vaccination program indicators globally and in World Health Organization (WHO) regions in 2024, and compare the values in 2024 and 2019. <b>Methods</b>: Global and regional values for routine DTP vaccination performance indicators were assessed in 2024. Means and percentages in 2024 and 2019 were compared using the <i>t</i>-test and Chi-square test, respectively, considering <i>p</i> < 0.05 as statistically significant. High-priority countries for DTP vaccination coverage increase were identified in each WHO region based on the indicators assessed in this study. <b>Results</b>: The global mean vaccination coverage for DTP1, DTP3 and three DTP doses were 90.7%, 86.6% and 72.8%, respectively, in 2024. Eight of the ten indicators assessed in this study worsened and two improved globally from 2019 to 2024. The differences between 2019 and 2024 were statistically significant for the three-dose DTP coverage decrease in the European WHO region (88.1% vs. 82.5%, <i>p</i> < 0.05), and the decrease in the global percentage of countries with ≥90% three-dose coverage (34% vs. 21%, OR = 0.52, 95% CI: 0.33-0.81, <i>p</i> < 0.005). This study identified 27 (13.8%) high-priority countries for DTP vaccination coverage increase due to DTP1 coverage lower than 80%; 47 (24.1%) countries due to DTP3 coverage lower than 80%; and 48 (24.6%) countries due to three-dose coverage lower than 60%. <b>Conclusions</b>: Global and regional DTP vaccination performance indicators in 2024 did not recover to pre-pandemic levels, although the differences between 2024 and 2019 were statistically significant only for two regional indicators.