Auxiliary nurse Claudia Guillermo administers a measles vaccination to 1-year-old Jimena Nicole Xoj Caal at a UNICEF-supported health centre in the city of Cobán. | CREDIT: © UNICEF / NYHQ2012-2216 / SUSAN MARKISZ

Here’s How Much Even a Small Decrease in Measles Vaccine Coverage Will Cost Hospitals in the US

About 93% of children aged 2 to 11 in the United States have received their Measles, Mumps Rubella Vaccine–MMR last year.  This is despite an active disinformation campaign about vaccine safety that is pushing vaccination rates lower. Part of this campaign includes measures in some states that allow parents to opt their children out of these life saving vaccines. Permissive “non-medical exemption” laws let parents refuse these vaccinations out of personal belief.  In some states, rates for non-medical exception exceed 6%.

Now, a new study from the Journal of the American Medical Association shows how a even a slight decrease in MMR vaccination rates could cause new outbreaks. And, for the first time, it calculates the direct public sector costs associated with new measles outbreaks caused by declining vaccination rates.

The study by Nathan C. Lo, and Peter J. Hotez models a 5% reduction in MMR vaccination coverage to find a three fold increase in annual measles cases in the United States, to about 150 cases, resulting in an additional $2.1 million in public sector costs. These costs come to about $20,000 per measles case and include state and local expenses, personnel wages and salaries, contact tracing, lab work and other costs associated with stopping an outbreak.  

On the other hand, the study finds that eliminating “personal belief” exemptions would increase national MMR coverage from 95%, reducing annual measles cases by 20%. The study determined that eliminating non-medical exemptions was an “effective strategy to mitigate annual measles cases and costs.”

Some states are catching on. Two years ago, California State Senators Ben Allen and Richard Pan introduced legislation to eliminate the state’s personal exemption loopholes, which had caused a skyrocketing rate of children who did not receive their routine immunizations. After a measles outbreak in Disneyland resulted in 140 cases, this cause took on new urgency. California joins several other states that have put strict limitations on who can opt out of vaccine coverage, though 18 states still have permissive personal exemption laws. 

This all matters because measles is a highly infectious disease.  If vaccination rates fall below 90% “herd immunity” is undermined. Measles is routinely imported to the United States from countries and regions where it is still endemic. If the local population is not protected, then outbreaks will occur. And now, for the first time, we know exactly how much money an outbreak will cost already strained public health systems in communities around the United States.


Bonus: Listen to my interview with one of the study’s authors, Dr. Peter Hotez who is one of the country’s leading public health experts.