PRETORIA, SOUTH AFRICA — Health authorities responding to the South Africa measles outbreak have registered 3,462 laboratory-confirmed cases since January 2026, driven by a sharp drop in routine childhood immunizations. Official data shows that the proportion of unvaccinated infants tripled over nine years, climbing from 12.1 percent in 2017 to 36.3 percent between January and April 2026.
Epidemiological clusters are concentrated in the Western Cape, Free State, KwaZulu-Natal, and Northern Cape provinces, predominantly affecting pediatric patients aged one to 14.
Declining Immunization Rates Accelerate the South Africa Measles Outbreak
Foster Mohale, spokesperson for the National Department of Health, confirmed that routine coverage metrics have declined significantly across essential primary healthcare services. First-dose measles coverage among children under one year old dropped from 87 percent in 2021 to 67 percent in 2025.
Immunization Type
2021 Coverage
2025 Coverage
Target Threshold
Measles First Dose
87.0%
67.0%
90.0% (WHO)
Hexavalent Vaccine
87.0%
60.5%
90.0% (WHO)
Gaps in Herd Immunity and Health System Impact
The World Health Organization (WHO) specifies a 90 percent immunization coverage threshold to establish herd immunity and interrupt endemic measles transmission. South Africa’s current coverage sits 23 percentage points below this baseline. Furthermore, coverage for the Hexavalent vaccine—which protects against diphtheria, tetanus, pertussis, polio, hepatitis B, and Haemophilus influenzae type b—has fallen to 60.5 percent.
Why It Matters: Decreasing routine immunization coverage within one of Africa’s most developed health systems highlights growing regional vulnerability to large-scale vaccine-preventable disease outbreaks.
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