The Western Cape’s health authorities are raising concern over a steady dip in childhood immunisation rates, a trend they say could undo years of progress and leave thousands of infants exposed to preventable illnesses.
This comes as fresh data shows the province remains well below the 95% threshold required to maintain herd immunity.
Drawing from figures highlighted by Cape {town}Etc`s reporting a few months ago, provincial health specialists say the decline mirrors national patterns that began during the Covid-19 pandemic and have since been worsened by vaccine hesitancy and service disruptions.
Speaking about the latest figures, Professor Hassan Mahomed of the Western Cape Department of Health and Wellness explained that vaccine coverage for children under one year had dipped to 67.4% in 2024/25, compared with 67.6% the previous year.
‘This is a significant gap that leaves thousands of infants vulnerable to preventable diseases,’ he said.
Mahomed added that teams were responding through clinic-based services, community outreaches and door-to-door visits to make vaccines more accessible.
He noted that hesitancy had become a ‘significant barrier’ locally and globally, stressing the need for clear community communication to rebuild public confidence.
Public health voices say the pattern is not just isolated to the Western Cape.
Professor Shabir Madhi, who is the Dean of the Faculty of Health Sciences at the University of the Witwatersrand, believes the Western Cape’s electronic data systems make its reporting among the most reliable in the country, as per the Daily Maverick’s.
‘For other provinces, it’s really difficult to unpack what the trends are,’ he explained.
He referred to a 2019 survey that already showed ‘quite a bit of heterogeneity’ across districts, confirming wide variations in coverage long before the pandemic.
Nationally, the South Africa Child Gauge 2025 found that only 83.3% of infants under one were fully immunised in 2023/24, which is still short of national targets.
Health officials say the impact of declining coverage is visible. According to Mahomed, lower immunisation rates have influenced measles and diphtheria outbreaks across the Western Cape.
He confirmed that measles cases reached 282 laboratory-confirmed infections between January and November this year, mostly in the Cape Town metro, though no deaths were reported.
Diphtheria, meanwhile, affected 138 individuals nationally, with the Western Cape accounting for 73% of cases, including 57 respiratory infections and 44 carriers. Ten deaths were recorded in the province, three of them children under the age of 15.
Mahomed emphasised that diphtheria is preventable through routine childhood vaccinations with scheduled boosters at 18 months, six years and 12 years.
In November, all public health facilities nationally supported a National Immunisation Catch-up Drive, offering free vaccines, vitamin A supplementation, school and preschool visits and additional health education.
In targeted areas of Khayelitsha and the Eastern Substructure, more than 13,000 immunisations had been administered by mid-November.
‘The main focus of the catch-up campaign is to find children who have never been vaccinated or have missed vaccinations at any age, not just infants,’ Mahomed explained.
Madhi also believes that while childhood vaccines are essential, countries should increasingly focus on adult and maternal immunisation to reduce hospital admissions and prevent illness among older or high-risk groups.
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