Cost Implications of Declining MMR Coverage in England: Modeling NHS Burden and the Value of Catch-Up Vaccination
Author(s)
Kerry Winter, MSc, BSc, Amy Pinsent, PhD, MS, BSc.
Thermo Fisher Scientific, London, United Kingdom.
Thermo Fisher Scientific, London, United Kingdom.
OBJECTIVES: MMR vaccination coverage in England has declined significantly since the start of the COVID-19 pandemic, contributing to a rise in measles outbreaks and increased vulnerability to vaccine-preventable diseases. This study aimed to estimate the economic impact on the UK National Health Service from excess measles cases resulting from declining MMR coverage and to compare this with the cost of delivering catch-up vaccination to unprotected infants.
METHODS: A cost-of-illness model was developed to assess the impact of reduced MMR vaccination coverage between 2019 and 2024 on additional measles cases and associated NHS costs. The model estimated both excess measles cases that may have already occurred due to reduced coverage and projected future cases in an outbreak scenario, assuming continued declines and accounting for infection severity. The model included direct NHS costs, such as case management and vaccination, and indirect costs from caregiver productivity losses. Costs were sourced from NHS, PSSRU, BNF, and ONS data.
RESULTS: Since the start of the pandemic, MMR vaccination coverage in England has fallen by approximately 2%, resulting in over 10,000 additional unvaccinated 2-year-olds compared with pre-pandemic levels. If exposed during an outbreak, this cohort's immunity gap could lead to over 4,200 additional measles cases, assuming a 41% attack rate among unvaccinated infants (UK Health Security Agency). NHS treatment costs were estimated at £1.62 million, with a further £1.26 million in caregiver productivity losses. In comparison, vaccinating these infants is estimated to cost £0.92 million. If the average annual decline in coverage of 0.43% continues over five years, the model projects an additional £79.01 million in total costs, including £51.77 million in direct healthcare costs and £27.25 million in productivity losses.
CONCLUSIONS: These findings highlight the importance of implementing catch-up vaccinations to address declining MMR coverage and prevent avoidable NHS costs and disease burden.
METHODS: A cost-of-illness model was developed to assess the impact of reduced MMR vaccination coverage between 2019 and 2024 on additional measles cases and associated NHS costs. The model estimated both excess measles cases that may have already occurred due to reduced coverage and projected future cases in an outbreak scenario, assuming continued declines and accounting for infection severity. The model included direct NHS costs, such as case management and vaccination, and indirect costs from caregiver productivity losses. Costs were sourced from NHS, PSSRU, BNF, and ONS data.
RESULTS: Since the start of the pandemic, MMR vaccination coverage in England has fallen by approximately 2%, resulting in over 10,000 additional unvaccinated 2-year-olds compared with pre-pandemic levels. If exposed during an outbreak, this cohort's immunity gap could lead to over 4,200 additional measles cases, assuming a 41% attack rate among unvaccinated infants (UK Health Security Agency). NHS treatment costs were estimated at £1.62 million, with a further £1.26 million in caregiver productivity losses. In comparison, vaccinating these infants is estimated to cost £0.92 million. If the average annual decline in coverage of 0.43% continues over five years, the model projects an additional £79.01 million in total costs, including £51.77 million in direct healthcare costs and £27.25 million in productivity losses.
CONCLUSIONS: These findings highlight the importance of implementing catch-up vaccinations to address declining MMR coverage and prevent avoidable NHS costs and disease burden.
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
EE174
Topic
Economic Evaluation, Epidemiology & Public Health, Health Policy & Regulatory
Topic Subcategory
Cost/Cost of Illness/Resource Use Studies
Disease
Infectious Disease (non-vaccine), No Additional Disease & Conditions/Specialized Treatment Areas, Pediatrics, Vaccines