Nearly one in 10 infants worldwide, or 12.9 million, received no vaccinations in 2016, the World Health Organization (WHO) said Monday.

Those infants missed the critical first dose of the triple vaccination against diphtheria, tetanus and pertussis, known as the DTP3 vaccination. An additional 6.6 million infants who received the first dose didn’t receive the other two doses in the three-dose series last year.

“Since 2010, the percentage of children who received their full course of routine immunizations has stalled at 86 percent, with no significant changes in any countries or regions during the past year,” WHO said in its statement. “This falls short of the global immunization coverage target of 90 percent.”

Current levels of immunization prevent 2 million to 3 million deaths worldwide every year from diphtheria, tetanus, pertussis and measles, according to WHO, which called routine vaccinations “one of the most successful and cost-effective public health interventions” that can be carried out.

One hundred and thirty of the 194 WHO member states have achieved the 90 percent DTP3 coverage benchmark. The majority of unvaccinated infants live in countries ensnared in conflict or encumbered by high levels of poverty.

In 2016, eight nations had coverage rates below 50 percent for DTP3 shots; they were Central African Republic, Chad, Equatorial Guinea, Nigeria, Somalia, South Sudan, Syria and Ukraine.

“If we are to raise the bar on global immunization coverage, health services must reach the unreached,” said Dr. Jean-Marie Okwo-Bele, WHO Director of Immunization, Vaccines and Biologicals. “Every contact with the health system must be seen as an opportunity to immunize.”

Despite the stagnant overall vaccination rates, WHO reported gains in vaccination for rubella, a virus that can cause severe birth defects if contracted by pregnant women. Global coverage against that disease increased from 35 percent in 2010 to 47 percent in 2016, according to Monday’s statement. WHO called the improvement a “big step toward reducing the occurrence of … a devastating condition that results in hearing impairment, congenital heart defects and blindness.”

The fight for broader vaccination rates is not unique to developing nations or war-torn regions. Earlier this month, the French government passed a law mandating that by 2018, French parents will be required to vaccinate their children against a range of diseases, including pertussis, measles, mumps, and rubella. France already requires vaccinations against diphtheria, tetanus and poliomyelitis, with exceptions for infants with certain medical conditions.

The new law is a response to a movement against vaccinations in developed countries. In America, Britain and France, the measles vaccination rate has fallen just below the 95 percent level.

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