On Feb. 20, 2026, a research study lead by the Yale School of Public Health shows the resurgence of measles in the United States, driven by declining childhood vaccination coverage, poses a substantial public health and economic threat. The cost per case varied widely across counties and was inversely correlated with local population immunity levels.

Using county-level MMR vaccine coverage data and spatial incidence models, the team quantified the economic burden of measles in 2025 and projected the impact of continued declines in vaccine uptake. The researchers modeled a scenario in which coverage among children aged 0–6 years declined by 1% per year, reaching a 5% absolute reduction by year 5 relative to baseline.

This scenario produced 17,232 (50% High-Density Interval (HDI): 9,177–26,428), 4,085 (50% HDI: 2,184–6,210) hospitalizations, 36 deaths, and $1.50 (50% HDI: $0.90–$2.85) billion in annual costs in 2030, with a cumulative cost of $7.77 billion over 5 years. These findings demonstrate that even marginal reductions in MMR vaccine uptake can result in disproportionately large health and economic burdens. The study, non–peer-reviewed, was published in medRxiv.

As measles has been rare in the US for the past three decades, its symptoms may not be widely recognized, contributing to under reporting. While a mild case may include the characteristic measles rash of flat red spots accompanied by other nonspecific acute viral symptoms, approximately 20% of cases will progress to higher severity. In 2025, 19% of reported measles cases among children younger than 5 years required hospitalization.

MMR vaccination coverage among US kindergarteners has declined steadily since the 2019–2020 school year, coinciding with the resurgence of measles nationally. Since the 2022–2023 school year, kindergarten MMR coverage has dropped by approximately 0.3–0.4 percentage points annually.

In 2025, the US experienced its largest number of annual measles cases since 1992. The team estimated that measles outbreaks in 2025 incurred $244.2 million in societal costs, corresponding to $104,629 per case.

Between 1994 and 2023, measles vaccination prevented an estimated 104 million cases and 85,000 deaths in the US. Continued erosion of MMR coverage threatens to reverse these gains, imposing substantial and rapidly escalating health and economic costs. Sustained investment in vaccination policy, public health infrastructure, and global immunization efforts is therefore paramount to protect population health and alleviate the socioeconomic impact of measles.