OBJECTIVES

Measles is preventable and can be eliminated by vaccination. This research aimed to estimate the budget impact of increasing the two-dose measles, mumps and rubella (MMR) vaccination rate in each US state to 95%; the World Health Organization recommendation for countries aiming to eliminate measles.

METHODS

A budget impact analysis was conducted from a public sector perspective based on a previously published predictive model of measles outbreaks in US children over one year (Lo and Hotez, 2017), to provide state-level outcomes. The analysis used the latest publicly available data from the US Centers for Disease Control and Prevention (CDC). The public sector cost of a two-dose MMR vaccination was obtained from the CDC Vaccines for Children price list. The cost per case of measles to the public sector was varied from its base case value ($66,643) in scenario analyses.

RESULTS

To achieve a US-wide two-dose MMR vaccination rate of 95%, vaccination of an additional 827,085 individuals would be required at a total outlay cost of $3,482,028 ($4.21 per individual), with an estimated budget impact of $2,261,141 ($2.73 per additional person vaccinated). Six states already had a childhood MMR vaccination rate of greater than 95%. For the remaining 44 states (plus District of Colombia), the budget impact per state ranged from -$744 (Tennessee) to $414,578 (California). When the public sector cost per case of measles was increased to an upper estimate of $114,286, six of these remaining states were estimated to produce budget savings, indicating that increasing vaccination can be fiscally prudent, in addition to improving health outcomes.

CONCLUSIONS

Increasing the MMR vaccination rate to achieve 95% coverage in all US states is expected to have a minimal budget impact. This research supports the case for increased childhood MMR vaccination in the US. Lo and Hotez. 2017. JAMA Pediatrics 171(9):887-892.