Health Department urges urgent action as childhood vaccinations fall

The Department of Health has called for urgent national action to address declining childhood immunisation coverage, warning that the trend could trigger further outbreaks of vaccine-preventable diseases and reverse years of progress in reducing infant and under-five mortality.

Departmental spokesperson Foster Mohale said the proportion of infants receiving no vaccinations had increased sharply, from 12.1% in 2017 to 36.3% between January and April.

He said the increase had left hundreds of thousands of children vulnerable to potentially life-threatening diseases.

Routine immunisation coverage has declined across all 52 districts in the country. First-dose coverage among children under one year fell from 87% in 2021 to 67% in 2025, while coverage of the hexavalent, or six-in-one, infant vaccine dropped from 87% to 60.5% over the same period.

Mohale said South Africa was unlikely to reach the World Health Organisation’s recommended 90% childhood immunisation coverage threshold without urgent intervention.

The decline is already being reflected in disease outbreaks. Since January 2026, South Africa has recorded 3 462 laboratory-confirmed measles cases, with outbreaks reported in the Western Cape, Free State, KZN, Northern Cape and other provinces.

Children aged between one and 14 account for 70.9% of the cases, according to the department.

The department also raised concerns about the country’s continued protection against other vaccine-preventable diseases.

South Africa has maintained its polio-free status since 2014, but imported poliovirus strains were recently detected in wastewater in Cape Town.

Sporadic cases of diphtheria have also been reported, mainly in the Western Cape, while cases of pertussis, commonly known as whooping cough, have been identified in several provinces.

The department said pertussis was particularly concerning because infants younger than six months are too young to be fully vaccinated.

Almost 400 cases of rubella, or German measles, have also been recorded, predominantly among children aged one to 14. The disease poses a particular risk to pregnant women because infection during pregnancy can result in Congenital Rubella Syndrome.

Mohale described the decline in immunisation as a public health emergency requiring coordinated action from government, healthcare providers, families and communities.

As part of its response, the department is prioritising catch-up vaccination campaigns targeting children who have missed routine doses and under-immunised groups across all districts.

Parents and caregivers are urged to take children who have missed vaccinations to their nearest healthcare facility or healthcare provider for routine and catch-up immunisation.

The department is also appealing to the public to obtain vaccination information from official government sources and avoid relying on unverified claims and misinformation circulating on social media.

Mohale said adequate vaccine supplies and cold-chain infrastructure were being maintained nationwide to ensure that access constraints did not prevent children from receiving vaccinations.

He added that vaccines used in South Africa are evaluated and registered by the South African Health Products Regulatory Authority for safety and effectiveness.

The department warned that outbreaks could have consequences beyond illness, including prolonged school absences, disruption to children’s development and negative effects on mental well-being.

Families may also face financial pressure when parents are forced to stay home with sick children or when children are excluded from school.

The Department of Health said protecting children from vaccine-preventable diseases was a shared responsibility and urged families and communities to act immediately to close immunisation gaps.