The Cost of Central Ohio’s Measles Outbreak

The Basic Info

The measles outbreak in central Ohio that sickened 85 children was declared over in early February, officials at Columbus Public Health announced. Thankfully none of the children died, but 36 were hospitalized.

The outbreak of measles infections, which was first reported in early November, spread among children who were not fully vaccinated and was mostly driven by a lack of vaccination in the community. Among the 85 cases, all but five were ages 5 and younger.

Health officials fought the outbreak by “sounding the alarm,” including being transparent about the state of the outbreak, informing the public about how easily the measles virus can spread and promoting the importance of getting young children vaccinated against the virus, said Dr. Mysheika Roberts, health commissioner for the city of Columbus, who led the outbreak response.

Experts recommend that children receive the measles, mumps and rubella – known as the MMR – vaccine in two doses: the first between 12 months and 15 months of age and a second between 4 and 6 years old. One dose is about 93% effective at preventing measles if a person comes into contact with the virus. Two doses are about 97% effective.

Measles was declared eliminated in the United States in 2000, and since then, most cases in the US have emerged in communities with low rates of vaccination against the virus. Even if a disease is eliminated, outbreaks can still occur if an unvaccinated person travels to or from a country where the disease is still common, becomes infected and brings it back to the United States, introducing the virus into a community. That traveler can transmit measles to anyone who is unvaccinated.

Estimating the Cost of the Outbreak

Disease outbreaks can incur substantial costs for public health departments and communities, but how much exactly? While the numbers in central Ohio are still being calculated for the recent measles outbreak, experts can estimate the financial burden using data from previous outbreaks across the United States.

A 2020 review of recent outbreaks (found here) looked at cost estimates based on 10 studies of 11 previous U.S. measles outbreaks:

• Median total cost per outbreak: $152,308 (range, $9,862-$1,063,936);
• Median cost per case: $32,805 (range, $7,396-$76,154);
• Median cost per contact: $223 (range, $81-$746);
• Approximate cost per day of investigation: $4,000.

A 2021 study in Pediatrics (found here) focused on costs from the societal perspective resulting from an outbreak of measles in Clark County in Washington State. The outbreak included 72 confirmed measles cases from December 2018 to April 2019, very similar to the size of the outbreak here locally.

Estimating the impact using this more comprehensive lens included costs for the public health response (labor, material and contractor costs) direct medical costs (third party or patient out-of-pocket treatment costs for infected individuals) and productivity losses (lost productivity due to illness, home isolation, quarantine or informal caregiving).

The overall societal cost of the outbreak, the authors estimated, was about $3.4 million ($47,479 per case or $814 per contact). The majority of the costs, approximately $2.3 million, were incurred by the public health response followed by productivity losses (about $1.0 million) and direct medical costs (about $76,000).

The estimates “indicate that under vaccination can carry a substantial cost for individuals, communities and public health institutions and underscore the value of vaccination,” the study authors wrote in their conclusion.

One can assume that the outbreak in central Ohio will incur a similar yet slightly higher cost due to the total number of infections. This is a huge burden for the local health department and economy! Getting our children fully vaccinated is an easy way to prevent this from happening in the future.

For more information, please visit https://ohioaap.org/podcasts/ to listen to Ohio AAP’s podcast focused on lessons learned from the central Ohio measles outbreak.

Schedule a MOBI/TIES Training

While routine pediatric vaccination rates took a notable decline the past few years, the Ohio Chapter, American Academy of Pediatrics (Ohio AAP) is still working to provide important education and services to pediatric and family practices caring for children and adolescents across Ohio.

Ohio AAP is offering both in-office and virtual options of MOBI & TIES! All MOBI & TIES trainings include:

• Guidance on continuing immunization best practices
• COVID-19 vaccine
• New immunization schedules
• 1-hour CME for each session
• Scheduling at your convenience
• Free office resources including:
  • CDC’s Pink Book
  • Reminder/recall postcards
  • Resource packets filled with essentials on immunization best practices

Please contact Lory Sheeran Winland, Director of Immunization Programs, at lwinland@ohioaap.org to request a MOBI and/or TIES training.