The value of vaccination—and the cost of refusal or delay

Every year, the Centers for Disease Control and Prevention (CDC) issues an updated schedule of recommended vaccines for infants and children. Yet it’s estimated that some or all of the recommended early vaccines are being delayed or refused for as many as one in five U.S. children.

The number of vaccinations children must receive by age 2 may seem like a lot—more than two dozen vaccinations in total, with five or more vaccines given at some visits. But the schedule is designed to protect children from life-threatening, vaccine-preventable diseases as quickly as possible and when children are the most vulnerable. 

Significant savings provided by vaccines

Research published in the April 2014 issue of Pediatrics confirms that following the standard schedule of childhood vaccinations reduces the incidence of illness, resulting in significant savings for families and society. CDC researchers calculated the effect of routine vaccinations on a hypothetical cohort of nearly 4.3 million babies born in the U.S. in 2009, analyzing the benefits and costs from birth through death. The vaccines included these:

  • Diphtheria, tetanus, and pertussis (DTaP)
  • Haemophilus influenzae type b (Hib
  • Polio (IPV)
  • Measles/mumps/rubella (MMR)
  • Hepatitis B (HepB)
  • Varicella (chickenpox) (VAR
  • 7-valent pneumococcal conjugate (PCV7)
  • Hepatitis A (HepA
  • Rotavirus 

Researchers projected the number of vaccinated and unvaccinated people. They also calculated the disease burden, considering direct medical and nonmedical costs (such as those related to vaccination, treatment and complications of the vaccine-preventable diseases, travel costs, and costs for missed work due to illness or caregiving) and societal costs (such as special education of children affected by disease or productivity losses caused by permanent disability or premature death related to disease).

Results indicated that following the childhood vaccination schedule would prevent about 42,000 early deaths and 20 million cases of disease. Direct costs that could be saved as a result of immunization would be expected to total $20.3 billion, while societal cost savings would top $76.4 billion. By comparison, direct and societal costs of the vaccination program were found to be $6.7 billion and $7.5 billion, respectively.

The authors concluded that childhood immunization “remains one of the most cost-effective prevention programs in public health,” and that “every dollar spent ultimately saves at least 10 dollars.” 

Suffering resulting from vaccine refusal

Although such research highlights the clear financial benefit of vaccinating, it doesn’t account for many of the costs of not vaccinating, including pain, sickness, disability, or even death, and the emotional and physical toll of vaccine-preventable illness on families. 

It’s true that many of the illnesses we vaccinate against are rare, and unvaccinated people may be unlikely to get them—thanks largely to “herd immunity” (also called “community immunity”) provided by those who adhere to the vaccination schedule. However, as fewer people vaccinate, that protection is eroded and the risk of illness increases. For example, community immunity for measles requires an 83 to 94 percent vaccination rate. When people who can be vaccinated opt out, there’s less protection for those who cannot be vaccinated, such as very young infants and people with compromised immune systems, including cancer patients and elderly people.

Communication between parents and providers

Parents should talk with their children’s health care providers about the potential costs of not vaccinating, including serious illness, hospitalization, sick days from school and work, and even death. Parents should weigh these potential costs when considering departing from the recommended vaccination schedule.

Last updated February 6, 2018

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