Measles Outbreaks Are Expensive

In The Politics of Autism, I analyze the myth that vaccines cause autism. This bogus idea can hurt people by allowing diseases to spread.    Examples include measles, COVID, flu, and polio.  A top antivaxxer is HHS Secretary RFK Jr. He is part of the "Disinformation Dozen." He helped cause a deadly 2019 measles outbreak in Samoa.

A release from the International Vaccine Access Center at Johns Hopkins:

The U.S. has reported more than 1,600 cases of measles to date in 2025, the largest number of cases since the disease was declared eliminated in 2000. Effectively responding to a measles outbreak imposes significant costs on national and state governments, healthcare providers, and society. The scale of these costs depends largely on the size of the outbreak, complicating economic calculations and making budgetary planning difficult. New research from the Economics & Finance team at the International Vaccine Access Center (IVAC) expands on previous costing research to quantify the costs of these outbreaks and better estimate how costs scale with outbreak size.

Researchers performed a systematic review to examine the cost of measles outbreaks in 18 states between 2000–2025. They found that the average cost per case was approximately $43,000, ranging from just under $7,000 to more than $243,000. This variation is the result of several factors, including the state the outbreak occurs in, the number of cases in the outbreak, and the number of contacts. Small outbreaks generally have a higher cost per case due to the high fixed expenditures required (e.g., surveillance, measles testing systems, communication systems, and labor mobilization), while large outbreaks have higher overall costs with a smaller cost per case.

A more useful metric may be the fixed cost of a measles outbreak, or the initial costs incurred at the beginning of a measles outbreak regardless of its size. Even a single case of measles triggers an outbreak response and therefore incurs a large initial fixed cost, including case investigation, contact tracing, quarantine, and vaccination. Beyond the initial fixed costs of a rapid health response, incremental costs continue to scale as an outbreak expands. In this systematic review, researchers estimated the fixed cost of a measles outbreak to be $244,480.40, with an incremental cost of $16,197.13 for each additional measles case. Based on recent evidence, using these figures, an outbreak of five measles cases could be expected to cost $325,466.05, while an outbreak of 50 measles cases is estimated to cost $1,054,336.90.

Economic Costs of Autism

In The Politics of Autism, I discuss costs and benefits of autism services.

Nicky Rogge and Juliette Janssen have an article at Journal of Autism and Developmental Disorders titled The Economic Costs of Autism Spectrum Disorder: A Literature Review

The abstract:

Autism is associated with a range of costs. This paper reviews the literature on estimating the economic costs of autism spectrum disorder (ASD). More or less 50 papers covering multiple countries (US, UK, Australia, Canada, Sweden, the Netherlands, etc.) were analysed. Six types of costs are discussed in depth: (i) medical and healthcare service costs, (ii) therapeutic costs, (iii) (special) education costs, (iv) costs of production loss for adults with ASD, (v) costs of informal care and lost productivity for family/caregivers, and (vi) costs of accommodation, respite care, and out-of-pocket expenses. A general finding is that individuals with ASD and families with children with ASD have higher costs. Education costs appear to be a major cost component for parents with children with ASD.

From the article:

Based on the studies reviewed, the overall lifetime costs for individuals with ASD are estimated to be situated somewhere between $ 2.4 million (in 2011 US$) (Buescher et al. 2014) to $ 3.2 million (in 2003 US$) (Ganz 2007) for the US and from £ 1.5 million (in 2011 £) (Buescher et al. 2014) to £ 2.4 million (in 1997–1998 £) (Järbrink and Knapp 2001) for the UK. As a total figure for the US, Leigh and Du (2015) estimated annual direct medical, direct non-medical, and productivity costs combined to be $268 billion (range $162–$367 billion; 0.884–2.009% of GDP) for 2015 and forecast this cost to be $461 billion (range $276–$1011 billion; 0.982–3.600% of GDP) for 2025. Moreover, as pointed out by some studies, reported cost estimation figures are likely to underestimate true ASD-related costs due to omitted health impacts, omitted economic impacts, omitted impact on social life, and the costs of health actions in other sectors.

...
[T]he cost of (special) education, EIBI and therapy, individual productivity loss, parental productivity loss, and (supported) accommodation and residential care are among the largest contributors to total lifetime costs for an individual with ASD. The recent anonymous online survey for children and adults with ASD organized across multiple EU-countries in a large-scale project (ASDEU 2018), found similar results, with the cost of special education services being the highest cost component, followed by the costs of tutorial support, especially among younger people with ASD. Medical and healthcare costs related to ASD have been found to constitute only a small part of the total costs for individuals with ASD, with medical costs being higher for adults with ASD than for children with ASD. Estimates also show that smaller out-of-pocket expenses related to ASD, such as travel costs, cost related to making the house more ASD-friendly, purchase of specialised tools or equipment, etc., cannot be ignored when analysing the costs related to ASD. Summed together, all these out-of-pocket expenses can place a significant financial burden on the family budget. As to the costs of ASD-related therapies, due to the differences in therapy categorization and widely divergent cost estimates for ASD therapies, it is difficult to get a clear picture of the costs of therapy and/or EIBI programmes for individuals with ASD. Nevertheless, the studies that assessed the cost-effectiveness of EIBI for (young) children with ASD found that such therapy programmes are cost-effective and can result in cost savings throughout the lifetime of individuals with ASD.

The Costs of Caring

It is important not to see ASD people as "costs."  They can make great contributions to society.  Nevertheless, the costs of caring for people with autism -- especially children -- deserve frank attention.  Jeff Howe, the journalist who coined the term crowdsourcing, has a son named Finn, who is on the spectrum.  He writes at Money:

What we share in common with the parents of all those special-needs children is that our kids have almost nothing in common: Within the "autism spectrum" alone there is far more diversity than there is within the rest of the human population. As one clinical psychologist told me, "Saying you study autism is like saying you study the world of non-elephant animals."

Special-needs parents do share one thing: the eviscerating cost of our children. It's one of the awful ironies of this unchosen life. Not only do we divorce more frequently [not accurate -- ed.] and suffer from more mental health problems, but we pay dearly for the privilege.

... 

Well before Finn hits 22, a wave of disabled children will "age out," requiring massive amounts of state assistance. So just as baby boomers start putting unprecedented stress on government benefits, a slightly smaller but still significant population of disabled people will be in need of government help too.

"People assume the state will be there to help with their child," [financial planner John] Nadworny says, "but that's a really risky bet."
...

The final frontier for us (and, I suspect, many other families like ours) is to create a will and trust for our children. This is not straightforward. There are specialized vehicles that provide for the care of a kid like Finn without endangering his government benefits. There is also, critically, something called a letter of intent, which spells out the terms of care for a person who can't express those needs himself. But someone needs to serve as trustee; another person needs to serve as guardian.

How do you ask even a close family member to shoulder what we have taken on? There is, in our case, no obvious contender and no obvious solution.

Autism and Cost

Autism Speaks reports:

Autism Speaks, the world’s leading autism science and advocacy organization, today announced preliminary results of new research that estimates autism costs society a staggering $126 billion per year (U.S.) – a number that has more than tripled since 2006, and annually in the U.K. has reached more than £34 billion (equivalent to $54 billion U.S.). The costs of providing care for each person with autism affected by intellectual disability through his or her lifespan are $2.3 million in the U.S. and £1.5 million ($2.4 million) in the U.K. The lifetime costs of caring for individuals who are not impacted by intellectual disability are $1.4 million in the U.S. and £917,000 in the U.K. (equivalent to $1.46 million). The Autism Speaks-funded research, conducted by researchers Martin Knapp, Ph.D., of the London School of Economics, and David Mandell, Sc.D., of the University of Pennsylvania, will be presented at the international conference “Investing in our Future: The Economic Costs of Autism,” hosted by Goldman Sachs in collaboration with the Child Development Centre and Autism Speaks, on March 31 in Hong Kong.

The Cost of Early Intervention in Australia

The Sunday Telegraph (Australia) reports :

PARENTS of autistic children are having to sell their homes or move overseas to access crucial treatment that costs up to $50,000 a year. [Figures are in Australian dollars. -- ed.]

Federal government guidelines recommend early intervention with a "minimum of 20 hours a week over two or more years" but its funding covers just an hour a week, advocates say.

"You're looking at $30,000 to $50,000 a year," said Nicole Rogerson from Autism Awareness Australia.

She said the government's "Helping children with autism package" of $6000 a year for two years is a "Band-Aid on a gushing wound" and only wealthy families can afford early intervention.

"It's a travesty," she said.

The Cost of Autism

The New York Times reports:

Treatment is extremely expensive. Direct medical and nonmedical costs can add up to as much as $72,000 a year for someone with an extreme case of the disorder, and even $67,000 a year for those on the lower end of the spectrum, according to a study from the Harvard School of Public Health.

That figure includes medical costs like doctor visits, prescriptions and occupational and speech therapy, as well as expenses for things like special education, camps and child care, said Michael Ganz, the author of the study, who is now a health care consultant.

...

“The numbers are just amazing,” said Pat Kemp, executive vice president of the advocacy group Autism Speaks, “Unless we attack this like a national health crisis, we’re going to have a huge economic crisis on our hands.”

The Ganz study is available here. As baby boomers retire, he noted, many of their adult children with autism will move into adult care.

Those costs, combined with very limited to nonexistent income for their adult children with autism combined with potentially lower levels of savings because of decreased income and benefits while employed, may create a large financial burden affecting not only those families but potentially society in general.