Each measles case in the 2025 US outbreak—the largest since the disease was eliminated from the country in 2000—cost $43,200, rising to $58,600 when including the public health response, Johns Hopkins researchers estimate in Vaccine.
Multiply that by the 2,289 confirmed US cases last year, and the total rises to $134 million, which would not, of course, include unreported cases. And this year’s outbreak, which last week reached 2,566 cases, according to the Centers for Disease Control and Prevention (CDC), would so far cost more than $150 million.
The team reviewed the literature published from January 2000 to October 2025, as well as reports from the CDC and all 50 state health departments. They also assessed how costs scale with outbreak size.
Public health responses include case investigation, contact tracing, quarantine, and vaccination campaigns. “These measures incur substantial economic and financial costs, with large initial fixed costs and incremental costs that continue to scale as an outbreak expands,” the authors noted.
Low vaccine uptake continues to drive outbreaks
The researchers identified 19 studies, as well as eight reports from the gray, or nontraditional, literature, that included outbreak-relevant costs in 18 states.
Outbreak size ranged from one to 802 cases. The average cost per case was an estimated $43,204, and the average cost per contact was $443. Average per-case costs ranged from $33,416 from the provider perspective to $58,591 when including the public health response.
These outbreaks are largely preventable through inexpensive and highly effective measles vaccination paired with system-level preparedness for effective containment.
The fixed costs of launching public health responses were an estimated $297,747, though with wide confidence intervals that indicate uncertainty. Incremental costs for each additional case were $16,300. Regarding outbreak size, the elasticity of the total costs was estimated at 0.86.
Despite the wide availability of vaccines, low uptake continues to lead to measles outbreaks, representing significant costs and public health burden. “These outbreaks are largely preventable through inexpensive and highly effective measles vaccination paired with system-level preparedness for effective containment,” the authors wrote.
“Since fixed response costs for any outbreak can be costly, our estimates provide improved data on how costs of measles outbreaks scale with outbreak size by isolating incremental costs associated incident new cases, as well as incident contacts, for use alongside budgetary planning and modeled risk assessments,” they added.
