South Africa records 3,462 measles cases as unvaccinated infants triple

South Africa has recorded 3,462 laboratory-confirmed measles cases since January 2026, and health authorities warn the outbreak is tied to falling routine immunisation coverage and a sharp rise in completely unvaccinated infants.

Who is affected and where

The Department of Health said outbreaks have been reported in the Western Cape, Free State, KwaZulu-Natal and Northern Cape, with the majority of confirmed cases occurring in children aged 1–14 years.

Vaccination coverage has fallen

Department spokesperson Foster Mohale told reporters that the proportion of infants under one year who receive no vaccinations rose from 12.1% in 2017 to 36.3% between January and April 2026, effectively tripling the number of completely unvaccinated children.

Mohale said routine immunisation coverage had fallen across all 52 districts and gave specific declines in first-dose and hexavalent vaccine coverage. He said:

“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.”

He cautioned that, at current rates, South Africa is unlikely to reach the World Health Organization’s 90% coverage threshold for childhood immunisation.

Additional vaccine-preventable diseases and risks

Mohale highlighted further concerns, saying sporadic cases of diphtheria have been detected primarily in the Western Cape and that pertussis (whooping cough) cases have been identified in several provinces, mainly affecting infants under six months.

He also reported nearly 400 rubella cases, mostly among children aged 1–14 years, and warned about risks for pregnant women because of the potential for congenital rubella syndrome (CRS).

On polio, Mohale noted that South Africa has maintained its polio-free status since 2014 but referred to the recent confirmation of imported polio virus strains detected in wastewater in Cape Town.

Department response and public advice

The Health Department said it is prioritising an immediate, coordinated national response that includes catch-up vaccination campaigns targeting children who have missed doses and under-immunised cohorts in all districts.

Mohale urged parents and caregivers to use official government platforms for immunisation information and to take unvaccinated children to health facilities for routine and catch-up immunisations. He emphasised vaccine safety and supply, saying:

“The department secures adequate vaccine supplies and maintains cold-chain infrastructure nationwide to ensure no child is left behind due to access constraints.”

“All vaccines used in South Africa are evaluated and registered by the South African Health Products Regulatory Authority (SAHPRA), confirming their safety and effectiveness.”

Consequences of declining coverage

Mohale warned that declining routine immunisation rates risk the resurgence of vaccine-preventable diseases, erosion of herd immunity and higher rates of long-term disability and death among infants. He said:

“Unvaccinated children can endanger infants and immunocompromised individuals who cannot be vaccinated, and weak coverage undermines early detection and rapid response to emerging threats.”

The department also noted social and developmental impacts, stating outbreaks can disrupt children’s early development through prolonged school absence and reduced access to structured learning, with potential negative effects on mental well-being. Families may face lost wages and employment instability when caring for sick children, the department added.

Call to action

The Health Department urged coordinated action across sectors, with particular emphasis on engaging families and communities where vaccination rates are lowest, and encouraged parents, caregivers and communities to visit the nearest healthcare facility or provider for routine and catch-up immunisations.