Childhood vaccination rates in South Africa have reached a critical point, with more than one in three infants under a year old receiving no vaccinations during the first four months of 2026. With measles spreading and immunisation coverage falling across every health district, the latest figures have prompted urgent calls to get routine childhood vaccination back on track.
South Africa’s childhood vaccination programme has protected generations of children against diseases including measles, polio, diphtheria, whooping cough and hepatitis B. However, recent Department of Health figures show that fewer children are receiving these routine vaccinations, creating gaps in protection that are now becoming increasingly visible.
The proportion of infants under one year who had received no vaccines at all increased from 12.1% in 2017 to 36.3% between January and April 2026. First-dose vaccination coverage among children under one also declined from 87% in 2021 to 67% in 2025, while coverage of the hexavalent six-in-one vaccine fell from 87% to 60.5% during the same period.
Measles Is Showing What Happens When Coverage Falls
Declining vaccination coverage has consequences beyond the figures. South Africa has experienced a substantial increase in measles, an extremely contagious viral infection that can cause complications including pneumonia and inflammation of the brain.
By 16 August 2026, the National Institute for Communicable Diseases (NICD) had recorded 3,891 laboratory-confirmed measles cases since the end of December 2025. Children between one and 14 years accounted for most reported cases.
Rubella, whooping cough and sporadic cases of diphtheria have also added to concerns about declining protection against vaccine-preventable diseases.
Why Are Childhood Vaccination Rates Falling?
There is no single explanation. Limited awareness about vaccination schedules, missed clinic appointments, difficulties accessing healthcare services and vaccine hesitancy can all contribute to children falling behind.
Furthermore, a child who misses one appointment may subsequently miss several vaccinations unless there is effective follow-up. The decline has been recorded across all 52 health districts, demonstrating that this is a national problem rather than one confined to a particular province or community.
What Does Falling Vaccination Coverage Mean for Other Children?
Vaccination provides direct protection to the child receiving it, but high coverage also reduces opportunities for infectious diseases to circulate through communities.
When vaccination rates fall substantially, this population protection weakens. Consequently, outbreaks become more likely and babies who are too young to have completed their vaccinations, as well as people who cannot receive certain vaccines for medical reasons, may face greater exposure.
South African health authorities have warned that declining vaccination coverage is contributing to the return and spread of diseases that can largely be prevented through routine immunisation.
What If Your Child Has Missed Vaccinations?
A missed vaccination does not automatically mean that the entire vaccination schedule must be restarted. Instead, healthcare professionals can assess which doses have already been given and determine what is required to bring a child up to date.
Parents should check their child’s Road-to-Health booklet, particularly if clinic appointments were missed, vaccinations were postponed because of illness or there is uncertainty about whether every scheduled dose was received.
Routine childhood vaccines provided through South Africa’s Expanded Programme on Immunisation are available through public healthcare facilities. Parents who discover a gap in their child’s vaccination history should contact their clinic or healthcare provider for advice on an appropriate catch-up schedule.
A Public Health Problem That Starts With Individual Records
Rebuilding South Africa’s childhood vaccination coverage will require action from government, healthcare services and communities, but there is also a practical step every family can take.
Take out your child’s Road-to-Health booklet and check it. If anything is missing, unclear or overdue, speak to your clinic or healthcare provider rather than assuming it is too late to catch up.
With vaccine-preventable diseases already circulating, closing those individual vaccination gaps has become increasingly important for protecting both children and the wider community.
Medical disclaimer: This article is intended for general informational purposes and does not replace medical advice. Always consult a qualified healthcare professional or clinic regarding your child’s vaccination schedule, missed doses or individual medical circumstances.
YOU MAY ALSO LIKE
Understand the differences between public and private 2025 South African childhood vaccination schedules to ensure comprehensive immunisation.
