Measles cases rise in South Africa: Health measures and vaccination efforts

The institute emphasized that although sporadic cases are recorded even in highly vaccinated areas, outbreaks usually occur where vaccination coverage is low, and many children are either unvaccinated or incompletely vaccinated (having received only one of the two recommended doses). Therefore, maintaining high vaccination levels is critical to preventing the spread of measles.

Current outbreaks and response measures

NICD reported that measles outbreaks continue across South Africa, with the Western Cape being the most affected province, particularly in Cape Town. New outbreaks have been recorded in the Fezile Dabi and Hariyep districts in the Free State, in Etxevinni, King Cetshwayo, and uMkhanyakude in KwaZulu-Natal, as well as in Piksela Ka Seme in the North Cape.

In response to a parliamentary question from a DA party representative, Minister of Health Dr. Aaron Motsoaledi stated that the ministry has implemented national and provincial measures to raise measles vaccination coverage to the target of 95%. These measures include strengthening routine immunization, activating catch-up campaigns for missed vaccinations, outbreak control activities in low-efficacy areas, using District Health Information System (DHIS) data to identify under-vaccinated and unvaccinated children, and providing targeted support to provinces and districts with low coverage.

Ministry of Health Strategy

Motsoaledi added that provinces are required to monitor first and second dose coverage, conduct searches for those who have not been vaccinated, strengthen outreach services, and improve vaccine availability at facility level. The ministry supports provinces through national coordination and the 'Big Catch-Up' initiative aimed at children who missed vaccination since 2022. Key efforts include improving cold chain infrastructure and enhancing micro-planning at the district and facility levels to cover children with zero or insufficient doses, including hard-to-reach areas.

At the provincial level, the focus is on district micro-plans, outreach services, mobilization in schools and communities, vaccination catch-up, and enhanced facility surveillance. All provinces have been instructed to develop immunization improvement plans. Provinces with the lowest coverage have received priority technical support. For example, Limpopo is receiving priority assistance to address the issue of low first-dose measles coverage, which includes strengthening district catch-up plans, improving identification of unvaccinated individuals, intensifying community mobilization, and monitoring stock availability.

The Minister noted that despite successes in strengthening immunization services and surveillance, the current coverage level remains below national targets and is insufficient to prevent the accumulation of susceptible populations and the risk of outbreaks. He explained that after the COVID-19 pandemic, coverage has declined due to increased vaccine hesitancy, missed opportunities for vaccination, difficulties in reaching under-vaccinated groups, and ongoing constraints within the healthcare system.