“South Africa’s Department of Health has reported a sharp decline in childhood immunisation coverage, with unvaccinated infants tripling since 2017. This drop has already triggered measles outbreaks in several provinces, raising fears of further epidemics and long-term health consequences.”
South Africa is grappling with a public health emergency as vaccination rates among infants and children have dropped to dangerously low levels. The Department of Health has issued a nationwide call for urgent action, warning that the country risks losing decades of progress in reducing child mortality and preventing infectious diseases.
Declining Coverage
- Unvaccinated infants rose from 12.1% in 2017 to 36.3% in early 2026.
- First-dose coverage among children under one year fell from 87% in 2021 to 67% in 2025.
- The Hexavalent vaccine (protecting against six major diseases) dropped from 87% to 60.5% in the same period.
This decline places South Africa far below the WHO’s 90% coverage threshold, leaving hundreds of thousands of children vulnerable.
Outbreaks Already Underway
- Measles: 3,462 confirmed cases since January 2026, with outbreaks in Western Cape, Free State, KwaZulu-Natal, and Northern Cape.
- Rubella: Nearly 400 cases, posing severe risks for pregnant women due to Congenital Rubella Syndrome (CRS).
- Diphtheria: Sporadic cases detected in Western Cape, highlighting gaps in booster coverage.
- Pertussis (Whooping Cough): Cases reported in multiple provinces, mostly affecting infants under six months.
Causes of the Crisis
Several factors contribute to the decline:
- COVID-19 disruptions to routine healthcare services.
- Misinformation and vaccine hesitancy, fueled by social media.
- Healthcare access inequalities, especially in rural districts.
- Logistical challenges, including vaccine stock-outs and distribution delays.
Risks to Public Health
The Department warns that without immediate intervention:
- Herd immunity will collapse, exposing vulnerable populations.
- Infant mortality could rise, reversing gains made since the mid-2000s.
- Imported polio strains, already detected in Cape Town wastewater, could spread if coverage remains low.
Government Response
The Department of Health is urging:
- Parents to take unvaccinated children to clinics immediately.
- Healthcare providers to strengthen outreach programs.
- Civil society to combat misinformation and promote vaccine confidence.
Expert Opinions
Public health experts emphasize that vaccination is one of the most cost-effective interventions. Dr. Stavros Nicolaou of the Pharmaceutical Task Group noted that “failure to act decisively now will undo decades of progress and place South Africa at risk of epidemics that were once under control.”
International Context
Globally, declining immunisation rates have led to measles resurgences in Europe and North America. South Africa’s crisis mirrors these trends but is compounded by its large population of vulnerable children.
Path Forward
To address the crisis, experts recommend:
- Mass immunisation campaigns targeting high-risk districts.
- Mobile clinics to reach rural communities.
- Digital tracking systems to monitor coverage in real time.
- Public education drives to counter misinformation.
Conclusion
South Africa’s immunisation crisis is a stark reminder that public health gains are fragile. Without urgent action, preventable diseases could once again become widespread killers. The Department of Health’s call to action is clear: vaccinate now, or risk losing an entire generation to diseases we already know how to prevent.
