Vaccination is very important during the first two years of a child's life, as their immune systems are still developing. This is the finding of the World Health Organisation and UNICEF. Vaccination is considered a protective shield for families and communities, so for the unvaccinated, they are very vulnerable to many diseases.

According to WHO and UNICEF, more than a third of children under one year old in Madagascar are not yet vaccinated. More than 300,000 children in this age group have not received any of the 16 doses recommended by the national immunisation schedule.

More than 1/3 of children under 1 year old are not vaccinated in Madagascar.

The recommended doses are compulsory, yet the rate of immunization has decreased considerably over the past three years. The UNICEF representative in the country, Jean François Basse, indicated that Madagascar remains one of the countries with the highest number of children "Zero back" of recommended vaccinations. According to an immunization coverage survey conducted in 2021, nearly 25% of parents interviewed said their children had not been vaccinated due to lack of time. Nearly 40% cited distance as the most common reason for not being able to do so.