Estimating the Financial Costs of Measles Outbreaks in the United States (pre-print publication)

Researchers from the Economics & Finance team at the International Vaccine Access Center (IVAC) conducted a systematic review of published literature and official reports from 2000 through 2025 to quantify the costs of measles outbreaks across 18 U.S. states. The analysis examined both fixed costs — incurred when any outbreak begins — and incremental costs that accrue with each additional case and contact. Findings are now available as a pre-print publication. 

Key findings

• Wide range of costs per case: Across settings, the average cost per measles case was approximately $43,000 (ranging from just under $7,000 to more than $243,000), reflecting variation in outbreak size, public health practices, and local healthcare expenses.
• High initial fixed costs: Even a single measles case triggers substantial response expenditures — including case investigation, contact tracing, quarantine, and vaccination campaigns — leading to an estimated fixed outbreak cost of ~$244,000 before cases accumulate.
• Incremental costs: Beyond fixed costs, each additional measles case adds roughly $16,200 in incremental response costs, showing how total financial burden increases with outbreak size.
• Cost dynamics vary by outbreak size: Small outbreaks tend to have higher cost per case due to upfront resource mobilization, while larger outbreaks incur greater total expenditures with lower cost per case ratios.

These findings provide improved estimates that can support budgetary planning and risk assessments at federal, state, and local levels. They underscore that declining MMR vaccination coverage not only increases disease risk but also exacts a substantial economic burden on public health systems and healthcare budgets. Investing in high immunization coverage and outbreak preparedness can help minimize both the health and financial impacts of measles resurgence.

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