Penny wise, pound foolish: The cost of reduced support for measles prevention

Area of Science:

• Public Health
• Epidemiology
• Health Economics

Background:

• Measles was previously eliminated in the US but is now reemerging.
• Over 1400 measles cases were reported in 2025, indicating a resurgence.
• Reduced vaccination coverage and decreased federal support for immunization programs contribute to this trend.

Purpose of the Study:

• To estimate the economic burden of a potential 1500-case measles outbreak in 2025.
• To analyze direct medical costs, productivity losses, and public health expenditures associated with measles outbreaks.
• To highlight the fiscal implications of declining vaccination rates.

Main Methods:

• Economic analysis incorporating direct medical costs.
• Estimation of productivity losses due to illness.
• Inclusion of public health response expenditures for outbreak management.
• Sensitivity analyses to assess cost variations based on key parameters.

Main Results:

• A 1500-case measles outbreak in 2025 is estimated to cost $90.0 million ($59,996 per case) under base-case assumptions.
• Sensitivity analyses show potential costs ranging from $16 million to $199 million.
• Costs are influenced by hospitalization rates, productivity loss assumptions, and public health response intensity.

Conclusions:

• The economic burden of measles outbreaks significantly outweighs the investment in current vaccine infrastructure.
• Reduced vaccination coverage poses a substantial fiscal risk to public health.
• Strengthening immunization programs and federal support is essential to prevent costly outbreaks.