Open Access Research article

The average cost of measles cases and adverse events following vaccination in industrialised countries

Hélène Carabin16*, W John Edmunds2, Ulla Kou3, Susan van den Hof4 and Van Hung Nguyen5

Author Affiliations

1 Department of Infectious Disease Epidemiology, Imperial College Faculty of Medicine, London, UK

2 Department of Economics, City University, London, UK

3 Vaccines and Biologicals, World Health Organisation, Geneva, Switzerland

4 National Institute of Public Health and the Environment, Department of Infectious Diseases Epidemiology, Bilthoven, The Netherlands

5 Agence d'évaluation des technologies et des modes d'intervention en santé, Montréal, Canada

6 Department of Biostatistics and Epidemiology College of Public Health Oklahoma University Health Sciences Center 801 NE 13th Street, Oklahoma City 73116, USA

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BMC Public Health 2002, 2:22  doi:10.1186/1471-2458-2-22

Published: 19 September 2002



Even though the annual incidence rate of measles has dramatically decreased in industrialised countries since the implementation of universal immunisation programmes, cases continue to occur in countries where endemic measles transmission has been interrupted and in countries where adequate levels of immunisation coverage have not been maintained. The objective of this study is to develop a model to estimate the average cost per measles case and per adverse event following measles immunisation using the Netherlands (NL), the United Kingdom (UK) and Canada as examples.


Parameter estimates were based on a review of the published literature. A decision tree was built to represent the complications associated with measles cases and adverse events following imminisation. Monte-Carlo Simulation techniques were used to account for uncertainty.


From the perspective of society, we estimated the average cost per measles case to be US$276, US$307 and US$254 for the NL, the UK and Canada, respectively, and the average cost of adverse events following immunisation per vaccinee to be US$1.43, US$1.93 and US$1.51 for the NL, UK and Canada, respectively.


These average cost estimates could be combined with incidence estimates and costs of immunisation programmes to provide estimates of the cost of measles to industrialised countries. Such estimates could be used as a basis to estimate the potential economic gains of global measles eradication.