| This week we learned that 2025 will be the worst year for measles cases in the US in 30 years, with the vast majority of infections happening in unvaccinated people. In Remarks for the August issue of Bloomberg Businessweek magazine, deputy editor Mark Milian writes how vaccines, in addition to saving lives, save employers money. Plus: A follow-up on the FDA and the opioid epidemic, how vocational schools are ready for the trade war, and why the FIFA Club World Cup is an invitation to injuries. If this email was forwarded to you, click here to sign up. For generations, parents everywhere recoiled at the sight of red blotchy spots on their child’s face. Although kids are prone to all sorts of weird rashes, the most feared ones were accompanied by a high fever; a dry, hacking cough; red, watery eyes; and small lesions inside the cheeks. Over the next several days, the rash would inch its way down the body, eventually reaching the feet. The measles virus is incredibly contagious, and in the worst cases it can require hospitalization, cause permanent disabilities and sometimes result in death. Another group also worried about measles: employers. Companies lose days of productivity when workers take off to care for sick children. Besides saving lives, this was another reason it was smart for the US government to help fund the development of an inoculation and why President John F. Kennedy signed a law expanding access to childhood vaccinations. In the decade after the measles shot arrived in 1963, the number of cases was cut in half, and according to the US surgeon general, the direct health-related savings during that time were at least $1 billion annually, adjusted for inflation. That number doesn’t account for productivity loss from overtaxed parents or the unspeakable tragedy of deceased children who could’ve grown up and contributed to society.  Illustration by Bryson Lee Not only do vaccines keep people alive and reduce long-term health complications from the diseases they prevent, but they’re also important to the economic health of a nation. Before widespread vaccinations, rich countries were poorer countries, with citizens who were sicker, less productive and more likely to die younger. Promoting vaccine use isn’t merely an ethical or public-health issue; it’s good economic policy. “Vaccines are one of the most cost-effective solutions in public health,” says Sachiko Ozawa, an associate professor at the Eshelman School of Pharmacy at the University of North Carolina at Chapel Hill. Hesitancy toward vaccines isn’t a new phenomenon. A religious backlash in Nigeria against the polio vaccine in 2003 led to a tragic resurgence of the disease there and throughout Africa. Barely a year later, parents were inoculating their kids again. The boycott was fueled by the same elements as anywhere else: misinformation and a lack of motivation to get a shot when you’re feeling healthy. After decades of gains, the developed world is going backward. In upper-middle-income and high-income countries, vaccination rates over the past decade have essentially plateaued or are declining, and more people are dying from preventable diseases, according to a study published last year in the journal Vaccine. In England the National Health Service reported that childhood coverage in 2024 had fallen by every measure, with several reaching their lowest levels since 2010. By contrast, countries supported by Gavi, the Vaccine Alliance, a public-private partnership that funds public-health efforts in poor economies, have improved coverage substantially and averted millions of deaths. Covid-19 accelerated the trend in wealthy countries. Government investment in vaccine development was a lifesaving and economically prudent decision, but inconsistent messages from health officials and falsehoods spread online shook the public’s trust. Part of the blame also rests with vaccine makers, Ozawa says. They overlooked the need to do marketing for the shots, wrongly seeing the pandemic as the only advertising required. “It’s like any product,” she says. “The manufacturers and distributors of vaccines were so focused on manufacturing and generating supply that they forgot about generating demand.” The stakes in poor countries are higher, because more people will die. But in the dispassionate calculus of pure economics, the costs of declining vaccination rates in places such as Canada, the UK and the US are exorbitant. A 2019 measles outbreak, in which 71 people were diagnosed with the disease in Clark County, Washington, cost $47,000 per person infected, according to a 2021 study in the journal Pediatrics. Most of the financial burden fell on the health-care system, but the next largest cost was to productivity. The toll would’ve been much greater if anyone had died—as two did in a measles outbreak this year in West Texas. The US set a dark milestone in July, when the number of cases so far in 2025 reached the highest level of any year since 1992. Even though the rate of return is good, wealthy governments are growing weary of investments in preventive care and in some cases are adding fuel to the sort of misinformation that stokes vaccine skepticism. In June the UK sharply reduced its contribution to Gavi, and US Health and Human Services Secretary Robert F. Kennedy Jr., a longtime vaccine critic, said America would stop funding it entirely—part of government-wide cost cuts championed by Elon Musk that disproportionately targeted foreign aid. At home, a Kennedy-appointed immunization panel within the Centers for Disease Control and Prevention withdrew support for inoculations containing mercury, used in about 5% of all flu shots to prevent bacteria, citing debunked concerns about the preservative’s safety. And restrictions on federal data imposed by President Donald Trump’s administration are making it tougher for the health-care industry to track infectious diseases and prepare for outbreaks. With vaccination rates declining, other sicknesses loom as both significant public-health and economic disasters. In the US and many other parts of the world, the flu last season was among the most contagious and pernicious strains in at least a decade, and expectations for the next one beginning in the fall are grim. Experts are also worried about dwindling immunization rates against whooping cough, says Bryan Patenaude, an associate professor of health economics at the Johns Hopkins Bloomberg School of Public Health. (The school is supported by Michael Bloomberg, founder and majority owner of Bloomberg Businessweek’s parent, Bloomberg LP.) It all adds up to a public-health policy that’s not just bad on its merits but also astonishingly at odds with efforts to accelerate growth and solve problems such as the mounting national debt. Rich countries can afford to absorb some higher costs to care for sicker populations, but another Covid-scale pandemic or a severe strain of flu could critically injure their economies, Patenaude says. “A lot of it comes down to opportunity cost,” he says. “Prevention is often a lot cheaper than treatment.” |
