According to an analysis published this Monday in the journal JAMA Pediatrics, a 2013 measles outbreak linked to a vaccine-denying community in Brooklyn, New York, cost the city’s health department an estimated $394,448 in the resulting outbreak response.

From Ars Technica:

During the outbreak, which spanned March through July, health workers quickly mobilized to track down more than 3,300 people exposed to the highly contagious, potentially life-threatening virus. Workers then determined the vaccination status of those exposed and doled out prophylactic treatments or vaccines to those who would take them. To get the word out about the health threat, workers contacted local doctors’ offices, schools, and daycares. They also placed announcements in local newspapers, set up a telephone hotline, and held community briefings on the situation. Almost a third of the employees involved in the response were working outside of their job descriptions, diverting resources from other critical public health activities. The cost estimate combined a conservative assessment of employee compensation ($332,000) and supply costs, such as lab testing and advertising ($62,000).

There were 58 confirmed cases of measles due to the outbreak, which was sparked by an infected teenager who brought the disease back from London. Mostly young children were affected and all the cases involved members of Brooklyn’s Orthodox Jewish community.

Of the 58 cases, 45 involved adults who refused to vaccinate, and 12 involved infants who were too young to be vaccinated. The outbreak also caused one person to develop pneumonia and a pregnant woman to suffer a miscarriage. A fetus that had been exposed to the virus in utero tested positive for the virus after birth. Even then, the baby’s parents reportedly refused treatment.

In an editorial accompanying the journal’s analysis, Yale’s Jason Schwartz wrote that the case is an example of how anti-vaxxers can fly under the radar while benefitting from herd immunity generated by surrounding communities that choose to vaccinate.

“Those who voluntarily choose to forego vaccination are thus free-riders, benefiting from this public good without contributing to it,” Schwartz wrote.

According to Schwartz, those who refuse to vaccinate should foot the cost of the resulting containment efforts.

“Such a fee would reflect the shared benefits among a community that result from a well-functioning vaccination system and the corresponding shared responsibility for contributing to and sustaining those benefits.”

Schwartz says the 2013 outbreak provides “additional evidence that decisions to delay or decline vaccination result in potentially serious health risks to those individuals and their communities as well as significant burdens and costs to health departments and the health care system.”

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