The primary reason to prevent the return of measles is that the virus can kill people, particularly those too young to have fully developed immune systems. When a virus produces no deaths, it is often treated as minor. However, a study of a single outbreak reveals the price paid by the public health system, diverting resources away from other diseases, and quite possibly triggering indirect deaths as a result. There’s a reason why those forced to clean up the mess hate anti-vaccination myths so much.
On March 13, 2013, an adolescent returning from a holiday in London brought the measles virus to New York City. Once home, this individual sparked an outbreak that infected 58 people, and exposed 3,351 to the virus in New York’s largest outbreak in 20 years. One miscarriage was attributed to infection, a child was born with the disease and another got pneumonia as a complication. Staff from the New York City Department of Health and Mental Hygiene (DOHMH) sprang into action. They interviewed patients’ families to establish symptoms and learn who they had been in contact with, conducted testing of serum samples for measles-specific antibodies, and administered vaccines to potential exposure cases.
By calculating the resources that went into preventing the outbreak from growing further, a paper in JAMA Pediatrics provides a good indication of the cost of similar outbreaks.
First author Dr Jennifer Rosen of DOHMH reports 10,054 hours of staff time were taken up, with a cost of $394,448 to the Department, all of which had to be diverted from other uses. An accompanying editorial notes health departments in smaller cities would be unable to muster similar resources.
In 2014, the United States had 667 measles cases, the highest number since the disease was locally eliminated in 2000. Since that elimination, outbreaks have, as in New York, involved an individual bringing the disease back from another country. Halfway through 2018, it is closing on being the biggest year of measles since 2014.
Even scaled for cases in big years, Rosen’s estimate of costs may not seem terribly alarming – it’s tiny compared to the cost of bringing a new medication to market, for example.
However, this is just the cost to the overstretched public health system – something that must be borne by society through paying your taxes. It doesn’t include the cost of treating those infected, nor days off work for parents.
All but one of those infected were unvaccinated, most because their parents had refused, but 12 because they were too young. A small increase in the non-vaccination rate would have sparked more infections, and more carriers to infect others, turning a controlled outbreak into an epidemic, with skyrocketing costs, again funded by society.
Anti-vaxxers argue the decision not to vaccinate is a private one, but so far none have offered to cover these public costs.
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