One in three South African infants is getting no vaccine at all.
Department of Health spokesperson Foster Mohale said on Wednesday the share of children under one who received zero vaccinations rose from 12.1% in 2017 to 36.3% between January and April 2026. That is a triple. He called the drop a public-health emergency.
The same briefing put laboratory-confirmed measles at about 3,462 cases since January 2026, with almost 400 rubella cases. Outbreaks were named in the Western Cape, Free State, KwaZulu-Natal, the Northern Cape and other provinces. The department said 70.9% of measles cases are in children aged 1–14.
Those department totals are already behind the laboratory ledger. The NICD week-33 sitrep, using data to 16 August, reported 3,891 laboratory-confirmed measles cases nationally and 480 rubella cases. New measles detections that week were highest in the Western Cape, then Limpopo and the Northern Cape. Treat 3,462 as the Wednesday political figure. Treat 3,891 as the later surveillance count. Do not flatten them into one number.
Coverage has been sliding for years, not weeks. First-dose coverage under one year fell from 87% in 2021 to 67% in 2025. Hexavalent (6-in-1) coverage fell from 87% to 60.5% over the same stretch. Mohale said routine immunisation has dropped across all 52 districts. South Africa is not on course for the World Health Organization’s 90% childhood coverage mark.
Herd immunity needs high two-dose measles coverage. When that falls, the virus does not look for a headline. It looks for the child with no card.
This is a coverage collapse with a case count attached. Unvaccinated infants tripled. First-dose and hexavalent rates fell in the same years. Measles and rubella then moved through children aged 1–14. Rubella is a separate problem for pregnant women because of congenital rubella syndrome. The department has announced catch-up. It has not, in this briefing, published how many extra doses were actually put into arms last month.
If you have a child under 15, read the Road to Health card before you argue on the group chat. Measles is two doses. Missing one is not “almost covered.” Clinics are where this gets fixed or stalls — stock, queues, and whether the nurse still has the antigen. Pregnant women should treat rubella as a real risk, not a footnote. The department’s 3,462 and the NICD’s 3,891 both point the same way: the virus is already circulating.
How many catch-up doses were given in July and August, by district? Which of the 52 districts are still under 95% measles coverage? And when will the department reconcile its Wednesday total with the NICD sitrep that is already higher?