Measles outbreaks could cost the US more than $1 billion a year, if vaccination rates drop

In early 2025, as measles began to sweep through West Texas, Katherine Wells knew she needed money.

Although the outbreak was centered in Gaines County, an hour away, Wells, who heads Lubbock’s public health department, needed more staff to respond to multiple exposures at local pediatricians’ offices, urgent care centers, restaurants and daycare centers.

“We were relying on hourly workers, because I can work 80 hours if I have to, which is terrible,” Wells said. In emergency planning meetings with the Texas Department of State Health, he pleaded for about $100,000 to hire part-time workers to help his exhausted staff.

“I was like, can I have the money that if I need a few hours of work from a retired school nurse that we used to work with, I can just pay them?” Wells said.

The answer, he said, was always “no.” The state sent a few travel nurses from other areas to help, but no additional money.

To prevent a measles outbreak from getting out of control, public health workers must take action, contact everyone with the virus as soon as possible, determine their vaccination status or health risk, and then try to persuade them to get vaccinated or stay at home for three weeks in isolation.

Wells pulled at least half of his staff to respond to the outbreak in addition to their other day-to-day duties.

What is the true cost of a measles outbreak?

Wells could not estimate how much it cost the Lubbock Health Department to contain the virus before the outbreak, which began in an unvaccinated Mennonite community in late January of last year, ended months later.

As of 2019, more than two-thirds of states and jurisdictions reported significant declines in vaccination rates, an NBC News/Stanford University investigation found. Among the states that track MMR rates, more than half of them – 67% – fall below the level needed to stop measles outbreaks.

A shocking new report calculates the price tag for the US if those rates continue to fall.

If measles vaccination rates continue to decline by 1% annually over the next five years, the cost to the US could reach $1.5 billion annually, according to a new report by the Yale School of Public Health.

Armed with existing state-level vaccination data, the Yale researchers used statistical models to calculate the predicted increase in measles cases, hospitalizations and their medical and social costs.

Based on their projections, $41.1 million will be needed each year to cover patients’ basic health needs, including health insurance, and $947 million for public health response efforts such as surveillance and contact tracing. Lost labor productivity, the report found, can reach $510.4 million each year.

Dr. Dave Chokshi, chairman of the Common Health Coalition, a nonprofit, nonpartisan public health organization partnering with Yale on the project, said measles outbreaks are occurring in all parts of the “health landscape.”

The human consequences of the measles outbreak are “important for us to address head-on,” said Chokshi, a former New York City health commissioner. “But we also wanted to make it clear that there are economic consequences, including lost workers, public health departments stretched too far to respond, and health care systems straining to deal with emergencies.”

Measles was declared eradicated in the US in 2000. Since then, outbreaks here and there have generally been quickly stopped. But declining vaccination rates have increased the risk of outbreaks and now threaten the country’s measles eradication status.

In late January 2025, as President Donald Trump took his second oath of office, measles cases were beginning to spread in West Texas. Under his presidency, following the leadership of Health Secretary Robert F. Kennedy Jr., the administration has not strongly endorsed vaccines as a way to end such outbreaks.

Instead, the message to vaccinate children focuses on “personal choice” rather than public health need.

In the first two months of 2026, there were more than 1,000 confirmed cases of measles, about half of the 2,281 in all of 2025. 94 percent of people infected with the virus were not vaccinated.

According to a recent analysis from the Johns Hopkins Bloomberg School of Public Health, the initial financial impact to the community from a measles outbreak is estimated at $244,480. That’s the amount that local and state public health departments can expect to pay for services such as vaccination clinics and staff until the outbreak ends, said study author Bryan Patenaude, an associate professor of health economics.

“We know the ingredients that deal with measles outbreaks, how many cases end up being serious and require care, because they must be properly tracked and documented,” said Patenaude.

The report, posted in October on medRxiv, a site that releases research before it’s peer-reviewed, tracked measles outbreaks in 18 states since 2004 (except for 2025 cases in Texas, Utah and Arizona).

On top of the upfront costs, each additional measles case costs about $16,000 a pop in contact tracing, medical costs and quarantine monitoring. Five cases of measles can cost $324,480, while an outbreak of 50 can cost $1 million, the Johns Hopkins report said.

In 2019, Clark County, Washington, experienced 72 measles outbreaks. Health officials have spent hours making sure people stick to isolation areas.

“We brought in staff from the state, the CDC, and other places as far away as Idaho to help us with case investigations and contact tracing,” said Dr. Alan Melnick, Clark County public health director. The team contacted the people who were in solitary confinement on a daily basis. In the end, 87% of subsequent measles cases occurred in people who had been isolated, Melnick said.

The assessment found that production losses from the small outbreak in Clark County rose to more than a million dollars.

The measles vaccine is free in the US

“The public should know what good policies are,” Melnick said, “because they save more money than they save lives.”

As a former California legislator, pediatrician Dr. Richard Pan helped strengthen the state’s vaccine requirements following the 2015 measles outbreak linked to Disneyland. “People need to realize that there are huge costs in this outbreak,” he said. “That cost, by the way, is borne by American families.”

South Carolina is struggling to contain the nation’s largest single-disease outbreak in more than a generation. Spartanburg County has been on high alert since the fall, with at least 1,000 cases and possible exposures at fast-food restaurants, stores, medical clinics and government offices.

The South Carolina Department of Public Health would not disclose the cost of contact tracing, mobile vaccination clinics and increased staffing.

A department official said the Centers for Disease Control and Prevention has approved a request to redirect several hundred thousand dollars previously allocated to emergency relief.

“Additionally, South Carolina requested and received $100k from the CDC available for vaccine-preventable disease responses,” said Louis Eubank, deputy incident commander at the South Carolina Department of Public Health, in a statement to NBC News. “South Carolina and the CDC continue to discuss additional funding needs and resource support.”

A top official at the US Department of Health and Human Services said the CDC sent $8.5 million to seven areas of the country affected by measles last year, but declined to say where or provide more details.

“Funds are released based on requests from state or local health agencies and the availability of funding from the CDC,” the person said.

As the South Carolina outbreak spreads to North Carolina, Dr. David Wohl, an expert in global health and infectious diseases at the University of North Carolina at Chapel Hill, has sought to prevent surgery for more than 23 confirmed cases.

“There are so many people working on this in my health care system,” Wohl said. “I can’t tell you how many calls, how many hours, how difficult people are.”

Intangible, indirect costs

The potential economic burden of a measles outbreak is easily calculated. The personal cost of having children unprotected from the world’s most contagious virus is immeasurable.

Hundreds of people infected with measles last year — more than one in 10, according to the CDC — were hospitalized with severe fever, pneumonia, difficulty breathing and dehydration.

Mothers and fathers have spent long, dim hours at their child’s bedside. Most have recovered. Others are left with the long-term effects of encephalitis – inflammation of the brain that can lead to seizures, blindness, hearing loss and learning disabilities.

Rarely, measles can hide in the body for ten years before re-emerging to attack the brain and nervous system. This condition, called subacute sclerosing panencephalitis, is almost always fatal.

Two little girls in Texas, ages 6 and 8, died of measles quickly, within weeks of being diagnosed.

While the economic consequences of measles outbreaks are real, the human impact cannot be ignored, Chokshi said. “Behind every figure is a child suffering from a serious illness, or a family unexpectedly hospitalized, and, in the worst cases, a death or long-term consequence of a preventable disease.”