The Many Costs of Measles Outbreaks and Undervaccination: Why We Need to Invest in Public Health.

Abstract

In 2018 and 2019, the United States weathered a resurgence of measles, with >1600 cases reported to the Centers for Disease Control and Prevention. Most of these cases were associated with large outbreaks in New York and a smaller outbreak in Washington.1 For the 2018–2019 school year, kindergarten coverage with two doses of the measles, mumps, and rubella vaccine was 94.7% nationwide, 97.2% in New York, and 90.8% in Washington.2 These recent outbreaks confirmed modeling studies revealing that localized pockets of undervaccination and higher vaccine exemption rates plus exposure to travel create fertile conditions for measles spread.3,4 In previous measles studies, the significant cost of public health response activities needed to control these preventable outbreaks have been quantified.5,6 In this issue of Pediatrics , Pike et al7 expand on previous outbreak assessments to present a comprehensive cost evaluation of the 2019 measles outbreak in Clark County, Washington. These authors include direct medical costs; economic consequences of lost productivity due to illness, quarantine, and caregiving; and public health response costs. The 2019 outbreak comprised … Address correspondence to Jessica R. Cataldi, MD, MSCS, Section of Pediatric Infectious Diseases, Department of Pediatrics, School of Medicine, Anschutz Medical Campus, University of Colorado, 13123 E 16th Ave, Box 055, Aurora, CO 80045. E-mail: jessica.cataldi{at}cuanschutz.edu