[Estimate of the cost/benefit ratio of measles vaccination]

Among primary health care programs, one of those that has the highest benefit/cost ratio is measles immunization. An estimate of cases, complicated cases and deaths that could have occurred if such immunization program would not have been run, and costs of medical care (hospitalization, physician's visits, medical treatment and rehabilitation), were calculated. Since population at risk has a steady-state given by those who enter -births- and releave it -when they are 15 years old-, if the program did not exist more than 2 million cases and at least 60,000 deaths from measles would have occurred annually. This hypothetical situation is compared with the actual situation of measles in Mexico during the 80's; 1) no more than 100,000 cases could have been estimated to occur in the very extreme case of notifying only one out of 10 cases. 2) The proportions of vaccinated and immune children under five reach 70 percent; this situation has produced 3) a fade out of epidemicity and has increased the critical size of community population for epidemics and doubled the interepidemic interval with the corollary of 4) increasing the average age of infection. The average cost of vaccinating a child was estimated near 1.25 dollars (US). Estimated costs of disease are related to individual losses. Taking into account these factors, benefit/cost ratio of measles immunization in Mexico is, at least, 100:1. Measles transmission patterns in Mexico are discussed since they lead to increase the benefit/cost ratio as compared to countries where the age of infection was put up before the immunization era. To expand investments on measles immunization is recommended.