Faced by a series of public health emergencies, Wild Polio Virus Outbreak, the protracted Cholera Outbreak, COVID-19 and Post Flood Recovery, Malawi’s health care delivery including immunization was gravely impacted in 2022. Coverage of the Third dose of the DPT vaccine was at 86% the lowest since 2018. The burden of zero- dosed and under immunized populations also increased rising to from 3% in 2019 to 6% in 2022 with widened equity gaps.