An active measles outbreak in Amajuba District, KwaZulu-Natal, has raised concerns about declining vaccination rates, with provincial second-dose coverage remaining below the level needed to provide community protection.
KwaZulu-Natal has recorded 93 confirmed measles cases this year, according to health authorities.
Medical expert Dr Angelique Coetzee says children are among those most affected, with 49 of the confirmed cases involving children aged between five and nine.
She says infants under the age of one have the highest attack rate and are particularly vulnerable to serious illness.
Children who are malnourished or have weakened immune systems also face a greater risk of developing severe measles.
Coetzee says children between the ages of one and 14 account for about 67% of confirmed measles cases nationally, while infants under one make up a further 12%.
The concern comes as KwaZulu-Natal's second-dose measles vaccination coverage stood at just over 88% during the province's most recent reporting period.
This is below the 95% coverage target considered necessary to maintain strong community protection against measles.
Coetzee says declining vaccination rates are putting young children at unnecessary risk.
She believes vaccine hesitancy is partly linked to younger parents not having witnessed the devastating effects of diseases such as measles because vaccination programmes have historically been successful in controlling them.
As a result, some parents may no longer fully appreciate the potential severity of vaccine-preventable diseases.
Coetzee says the decline in vaccination coverage is also occurring amid broader structural challenges and growing vaccine hesitancy.
She points to data from the World Health Organization and UNICEF showing that South Africa has experienced a significant decline in routine childhood vaccination coverage since 2019.
Health experts continue to urge parents and caregivers to ensure that children receive their recommended vaccinations to help prevent further measles infections and protect vulnerable members of the community.