March 02, 2026 | Geetika Nadkarni
Measles is a highly contagious infectious disease that was once rare in the United States. Per CDC, high MMR vaccination coverage in communities is important because a single person with measles can spread it to 90% of the people around them who are unvaccinated — simply by being in the same room. Due to historically high MMR vaccination coverage, the United States achieved measles elimination status in 2000. Unfortunately, outbreaks have increased since the COVID-19 pandemic amid declining vaccination rates, and it is now at risk of losing this status.
In 2025, there were 49 measles outbreaks and a total of 2,280 cases in the United States, with 93% being in unvaccinated individuals or those with an unknown vaccination status. These outbreaks take a toll on children, as they have the potential to cause severe health complications and lead to missed time at school. In addition, these outbreaks have financial and other associated costs to public health, health care, and society.
Estimates on the Cost of a Measles Outbreak
Researchers from the International Vaccine Access Center at the Johns Hopkins School of Public Health conducted a systematic review of all measles outbreaks in the United States between Jan. 1, 2000 and Oct. 7, 2025. As a result, they have released updated cost estimates for a measles outbreak in the United States, including:
The average fixed cost of an outbreak response.
The average cost per case.
The average cost per contact of each case.
Analysis from the public health perspective included evaluation of the direct medical costs of treatment, quarantine protocols, and other response activities (e.g., contact tracing and vaccination campaigns).
The study found that the average cost of a measles outbreak to public health agencies was $766,013.80 (ranging between $891.85 and $10,614,192.40). This figure includes the average fixed cost of approximately $244,480, which reflects the resources required to initiate an investigation. The health department then incurs an incremental cost per additional case at approximately $16,197. The analysis also found cost per case ranged from $9,430.90 to $243,614.79, and cost per contact ranged from $98.46 to $910.39.
These updated estimates can help public health agencies emphasize the need for robust immunization policies and programs as well as fiscal planning should an outbreak occur in their jurisdiction.
Public Health Implications
Given the new estimates, a public health department can face high costs when initiating an investigation even for a single measles case. These investigations include activities such as ramping up surveillance, testing, and communication, and the labor costs of mobilizing a response.
Measles outbreaks, which can include exposures throughout a community, not only put the health and safety of many individuals at risk but also incur a heavy financial burden on public health agencies. These outbreaks also divert staff and resources from other public health services. In addition, there are societal costs such as the cost of treatment, transportation, caregiver time, and loss of short- and/or long-term productivity (i.e., days lost at work and school).
Preventing Outbreaks and Planning for Impact
Maintaining high vaccination coverage remains the most cost-effective means of preventing outbreaks and protecting public health investments — not just for measles but for many diseases of public health concern. As vaccination rates decline in some areas of the United States and outbreaks continue to rise in 2026, understanding the cost of a response is increasingly important for public health officials, legislators, and other decision-makers.
Public health agencies should prioritize increasing vaccination coverage by…
Addressing misinformation through trusted messengers.
Improving vaccine-related health literacy among their community members.
Maintaining strong vaccination policies that limit non-medical exemptions.
While there were study limitations (i.e., a wide variability in cost reporting and cost breakdown), agencies must plan for the potential budgetary impacts of one or more outbreaks in their jurisdictions — particularly in areas with lower vaccination rates. This information can help educate lawmakers and the public on the cost of an outbreak and the cost-effectiveness of vaccinations. This is of utmost importance in jurisdictions considering legislation that would weaken school entry vaccination requirements.
Ultimately, these cost estimates combined with accurate information on vaccine safety and the health risks of measles (and other infections) can mobilize policymakers and the public to increase and sustain vaccination coverage in their communities.
Reviewed by Meredith Allen, DrPH, MS, Vice President of Health Security.