More than 70% of infections have been reported among children aged one to 14 as immunization rates fall
South Africa has recorded 3,462 confirmed measles cases since January 2026, with outbreaks reported in the Western Cape, Free State, KwaZulu-Natal, and Northern Cape, among children aged one to 14 years, the country’s Department of Health said on Wednesday.
Department spokesperson Foster Mohale said the proportion of unvaccinated children under one year old had increased from 12.1% in 2017 to an alarming 36.3% between January and April 2026. This effectively triples the number of completely unvaccinated children and leaves hundreds of thousands of infants at risk of life-threatening illnesses.
Mohale added routine immunisation coverage had fallen severely across all 52 districts in the country, which means that, at current rates, South Africa is unlikely to reach the World Health Organization’s critical 90% coverage threshold for childhood immunisation. He said the consequences of declining coverage include the resurgence of serious vaccine-preventable diseases, erosion of community, or herd immunity, and higher rates of long-term disability and death among infants.
“The majority of cases (70.9%) are in children aged 1–14 years, directly linked to low immunisation coverage,” Mohale stressed.
Mohale added that South Africa has maintained its polio-free status since 2014, while sporadic cases of diphtheria had been detected, primarily in the Western Cape, underscoring gaps in booster coverage and disease surveillance. Pertussis, or whooping cough, cases have also been identified in several provinces, predominantly affecting infants under six months who are too young to be fully vaccinated, Mohale said.
According to spokesperson, this poses severe risks for pregnant women because of the potential for congenital rubella syndrome (CRS). “Unvaccinated children can endanger infants and immunocompromised individuals who cannot be vaccinated, and weak coverage undermines early detection and rapid response to emerging threats.”
Mohale said the department is prioritising an immediate, coordinated national response, including catch-up vaccination campaigns targeting children who have missed doses and under-immunised cohorts in all districts. “Every child deserves protection, and safeguarding them is a collective responsibility,” he concluded.
