Health Department warns of immunisation crisis as unvaccinated children surge

The Department of Health is calling for an urgent national response to the sharp decline in childhood immunisation coverage, warning that the trend could reverse years of progress in preventing serious diseases and reducing infant and child mortality.

The proportion of infants under one year who have received no vaccinations has risen dramatically, from 12.1% in 2017 to 36.3% between January and April 2026.

The department says this effectively triples the number of completely unvaccinated children and leaves hundreds of thousands of infants vulnerable to potentially life-threatening illnesses.

Routine immunisation coverage has declined across all 52 districts in the country. First-dose coverage among children under one fell from 87% in 2021 to 67% in 2025, while coverage for the Hexavalent vaccine, which protects against six serious diseases, dropped from 87% to 60.5% over the same period.

At the current rate, South Africa is unlikely to meet the World Health Organization's recommended 90% childhood immunisation coverage threshold without urgent intervention.

The department is urging parents and caregivers to take children who have missed vaccinations to healthcare facilities for routine and catch-up immunisation.

The declining vaccination rates are already being linked to outbreaks of vaccine-preventable diseases in several provinces.

Since January 2026, South Africa has recorded 3,462 laboratory-confirmed measles cases, with outbreaks reported in the Western Cape, Free State, KwaZulu-Natal, Northern Cape and other provinces.

Children between the ages of one and 14 account for 70.9% of the confirmed measles cases, a trend the department says is directly associated with low immunisation coverage.

The department has also highlighted concerns about polio after imported strains of the virus were detected in wastewater in Cape Town. South Africa has maintained its polio-free status since 2014.

Sporadic cases of diphtheria, a serious bacterial infection that can cause breathing difficulties, have also been detected, particularly in the Western Cape.

Cases of pertussis, commonly known as whooping cough, have been reported in several provinces, with infants under six months particularly affected because they are too young to have received full vaccination protection.

The department says this is a sign that community immunity is weakening, putting vulnerable infants and other people who cannot be vaccinated at greater risk.

Almost 400 cases of rubella, or German measles, have also been recorded, mostly among children aged one to 14. The disease poses particular risks to pregnant women because infection during pregnancy can result in congenital rubella syndrome.

The Health Department has described the decline in routine immunisation as a public health emergency requiring a coordinated response from government, healthcare providers, communities and families.

As part of its response, the department plans to implement catch-up vaccination campaigns targeting children who have missed doses and those who are under-immunised across all districts.

It has also urged the public to obtain vaccination information from official government platforms and avoid unverified claims and misinformation circulating on social media.

The department says adequate vaccine supplies are secured and cold-chain systems are maintained across the country to ensure that children are not left without access to vaccines.

It further confirmed that vaccines used in South Africa are evaluated and registered by the South African Health Products Regulatory Authority (SAHPRA) to ensure their safety and effectiveness.

Parents, caregivers and communities are being encouraged to visit their nearest healthcare facility or healthcare provider to ensure children receive routine and catch-up vaccinations.

The department warned that disease outbreaks can have wider consequences for children and families, including prolonged school absences, disrupted early development and possible effects on mental well-being.

Families may also face financial pressure when parents have to stay home to care for sick children or when children are excluded from school, potentially resulting in lost income and employment instability.

The department says protecting children from vaccine-preventable diseases is a shared responsibility and requires immediate action from families, communities and the health sector.