The National Health Department is deeply concerned by the steep decline in immunisation coverage for children, which it said puts hundreds of thousands of children at risk of life-threatening illnesses.
It noted that between 2017 and April 2026, the proportion of unvaccinated children jumped from 12.1% to 36.3%. The decline has been noted across the country, adding that at the current rate South Africa would fail to reach the World Health Organisation’s “critical 90% threshold for childhood immunisations”.
“Routine coverage has fallen severely across all 52 districts in the country. First-dose coverage among children under one year dropped from 87% in 2021 to 67% in 2025. Coverage of the Hexavalent (6-in-1) infant vaccine declined from 87% to 60.5% over the same period,” read the department’s statement.
The department said the decline in vaccine uptake threatens to reverse decades of public health gains, especially considering recent outbreaks of diphtheria (primarily in the Western Cape); rubella, with nearly 400 cases recorded; and measles, with more than 3,400 confirmed cases reported since the start of this year.
“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. The majority of cases (70.9%) are in children aged 1–14 years, directly linked to low immunisation coverage.”
Cases of whooping cough have also been picked up in several provinces, especially affecting babies under 6 months, who are too young to be fully vaccinated.
Spokesperson Foster Mohale said the decline in childhood immunisation created a public health emergency.
The department also sought to reassure the public that all vaccines are evaluated and approved by the South African Health Products Regulatory Authority for safe use, adding that there is adequate supply nationwide. As such, it also urged the public to rely on official government platforms for accurate information on vaccines and immunisation.
“Unvaccinated children can endanger infants and immunocompromised individuals who cannot be vaccinated, and weak coverage undermines early detection and rapid response to emerging threats,” said Mohale.
The department reiterated its warning that disease outbreaks can have far-reaching impacts not only on childhood development through school absence and the like, but also on families. It called on parents, caregivers and all sectors of society to take urgent action to ensure that vaccination rates pick up again.
“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.”
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