Measles costs

Copenhagen, 22 April 2013

As European Immunization Week 2013 kicks off, WHO urges all 53 participating Member States in the European Region to consider the economic impact of measles and to restore or maintain effective national vaccination programmes, despite the difficulties of the economic downturn.

“Considering the human costs of measles, a preventable disease that can lead to long-term health complications and even death, we cannot afford to be complacent,” said Zsuzsanna Jakab, WHO Regional Director for Europe. “Achieving high vaccination coverage costs considerably less than an outbreak of measles, and economically, as well as medically, it makes no sense at all to wait for measles to strike when we have the means to eliminate this disease.”

• According to a 2009 study in Germany, the average cost of a measles case was €520 (equivalent to about US$ 680), including costs such as outpatient consultations and blood tests (1).
• An outbreak in Duisburg, Germany in 2006 led to the 311 schoolchildren affected missing a total of 2854 days of school, and the 30 employed adults affected losing a total of 301 days of work (1).
• A study of 10 western European countries revealed that a mother misses 8–24 hours of work in caring for a child with an uncomplicated case of measles (2).
• Over 2002–2003, the direct costs of measles incurred by the national health service of Italy were €17.6–22 million (about US$ 22.9–29 million). This would have paid for vaccinating up to 1.9 million children, which would also have prevented many cases of mumps and rubella. The 5154 hospitalizations during this period cost about €8.8 million (about US$ 11.5 million) (3).

Measles is highly contagious and requires high immunization coverage (over 95%) of any population if outbreaks are to be prevented. Unfortunately, many countries in the European Region have slipped from previously good vaccination coverage, and there have been over 90 000 cases of measles in the past three years. Outbreaks continue in a number of countries.

“Complacency and unfounded scares about vaccine safety have led to a situation where measles is just waiting to strike in many countries,” said Guenael Rodier, Director of the Division of Communicable Diseases, Health Security and Environment at WHO/Europe. “These countries could find they are hit hard economically. Scrimping on vaccination is a very expensive decision.”

Professor David Salisbury, Director of Immunization at the United Kingdom Department of Health, who works extensively for WHO’s global programme for vaccines, said: “It’s important also to take account of the indirect costs of measles, in terms of missed school days, loss of educational momentum and parents having to take days off work to look after their sick children.”

WHO recommends that each child receive two doses of measles vaccine, commonly combined with mumps and rubella vaccine (and called the MMR vaccine). This vaccine is one of the oldest and most effective in the world.

Notes to editors

• European Immunization Week (EIW) is an annual event aimed at raising awareness of the importance of immunization. The 2013 EIW is the eighth and will take place on 22–27 April. EIW acts as a focus for Member States to organize activities appropriate to their local situation. All 53 Member States in the European Region are taking part, with WHO providing technical and sometimes financial support where required.
• For EIW 2013, WHO/Europe has published a series of resources for Member States – such as the “TIP (tailoring immunization programmes) guide”, vaccine safety communication guidelines and a fact sheet on human papilloma virus (HPV) – on its web site.
• For interviews or further information, including data on your country’s immunization situation and contact details for the immunization focal points in your country, contact the WHO Regional Office for Europe staff listed below.

For further information, contact:

Robb Butler
Technical Officer
Division of Communicable Diseases,
Health Security and Environment
WHO Regional Office for Europe
UN City, Marmorvej 51
2100 Copenhagen Ø, Denmark
Tel.: +45 45 33 66 35
E-mail: rbu@euro.who.int

Stephanie Brickman
Communications Consultant
Division of Communicable Diseases,
Health Security and Environment
WHO Regional Office for Europe
UN City, Marmorvej 51
2100 Copenhagen Ø, Denmark
Tel: +45 45 33 68 44, +45 40 87 48 76 (mobile)
E-mail: sbr@euro.who.int

(1) Wichmann O et al. Further efforts needed to achieve measles elimination in Germany: results of an outbreak investigation. Bulletin of the World Health Organization, 2009, 87:108–115.

(2) Carabin H et al. The average cost of measles cases and adverse events following vaccination in industrialised countries. BMC Public Health, 2002, 2:22.

(3) Filia A et al. Measles in Italy, July 2009 to September 2010. Eurosurveillance, 2011, 16(29).