Measles Vax: A Public Health Investment, Not an Expense

As of late last month, the Centers for Disease Control and Prevention has recorded more than 1,600 measles cases, the most in three decades. These cases stemmed from 43 reported outbreaks, a sharp increase from just 16 in 2024. Over 200 patients have been hospitalized and three have died.

The human toll of these outbreaks is significant -- especially given that measles is entirely preventable when vaccination rates remain near the 95% threshold needed for herd immunity.

But beyond the devastating health consequences, the spread of measles creates an economic burden for patients, health insurance companies, and our government. My math suggests that a 1,500-case outbreak costs the United States anywhere from $16 million to $199 million in direct medical expenses, lost productivity, and public health spending.

This financial toll could grow exponentially in the years ahead if vaccination rates continue dropping further and further below the herd immunity threshold, resulting in more widespread outbreaks. Currently, less than 93% of kindergarteners are vaccinated against the measles, though rates vary substantially across states and within municipalities. If measles vaccination rates decline by just another 10%, the economic challenges could grow exponentially, and case rates could surpass the levels observed in the late 1980s and early 1990s.

This reality underscores the need to redouble vaccination efforts against the measles and other once-common childhood diseases -- so that Americans don't waste hundreds of millions of dollars responding to infections that could have been prevented for pennies on the dollar with vaccines.

The measles virus is extraordinarily contagious -- far more so than the flu. One infected person spreads the disease to 15 others, on average. Before the first measles vaccine became available in 1963, the disease infected three to four million Americans each year, hospitalizing tens of thousands and killing hundreds. That's why herd immunity is so essential: it's harder for a disease to tear through a community if most people are immune.

The direct costs of any measles outbreaks are relatively easy to measure -- simply add up all the medical bills tied to treating the disease.

Measuring indirect costs is a bit trickier, since the figure must account for lost productivity and lost wages while patients recover and the resources that families devote to caregiving.

Then there's the costs to health departments and state and local governments for expenses related to contact tracing, emergency pop-up clinics, and surge staffing.

Using the midpoint estimates from past measles outbreaks, modeling suggests that a 1,500-case outbreak this year would require about $9 million in direct healthcare spending, would cause productivity losses of $26 million, and necessitate public health spending of $55 million -- for a total cost of $90 million. But that figure could be as low as $16 million or as high as $199 million, depending on variables such as the share of infections that require hospitalization.

Michael Baker of the American Action Forum recently arrived at similar numbers when analyzing this year's largest single outbreak, where 762 people in West Texas fell sick, 99 were hospitalized, and two sadly succumbed to the highly infectious virus.

By his estimate, the Texas outbreak generated about $3.2 million in direct costs, productivity losses of $13.7 million, and $18.5 million in public health expenditures, for an estimated price tag of $35.4 million.

Vaccinating those 762 people, by contrast, would have cost between $40,000 and $115,000 in total, depending on whether the individuals receive shots through the federal Vaccines for Children program, or whether they have commercial insurance that pays higher reimbursements.

Such estimates don't even include the costs of measles' long-term health consequences. The disease can leave survivors with chronic complications, permanent disabilities, or rare but devastating brain disorders. It also wipes out the immune system's memory, leaving people more vulnerable to other infections for years.

And that's just for the measles -- it doesn't count the costs associated with all the other diseases we vaccinate against, like polio, pertussis, and rotavirus.  

Simply put, government spending on immunization programs offers taxpayers a staggering return on their investment by preventing exponentially greater expenses in the future. Reversing the decline in vaccination rates won't just save lives. It'll save our economy too.

Joey Mattingly, PharmD, MBA, PhD, is an associate professor and vice chair of research in the Department of Pharmacotherapy at The University of Utah College of Pharmacy.