Quora Question: If Measles Only Afflicts the Un-Vaccinated, Why Do the Vaccinated Care?

A measles vaccine is seen at Venice Family Clinic in Los Angeles on February 5, 2015. Lucy Nicholson/Reuters

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Answer from Jae Won Joh, MD.

Because we pay for it.

Americans always seem to forget that in our insurance-dependent health care system, the collective pays for the individual. Since the group suffers the cost when any given individual falls ill, it benefits everyone to do all that is possible to prevent anyone from requiring medical attention, and vaccines are just one small way to do this.

Let's go through an example with some rough cost estimates.

Jane decides not to vaccinate her child Jimmie. Jimmie becomes afflicted with measles after a trip to an amusement park, requiring a visit to his pediatrician.

Total cost thus far: $100

Jane stays at home from work to help take care of Jimmie (considering the economic implications of lost parental productivity is left as an exercise to the reader). Jimmie does not have an uneventful recovery and unfortunately begins to have seizures, prompting a 911 call and ambulance transport to the ER.

Total cost thus far: $1,100

In the ER, Jimmie is seen by an emergency physician who orders a full battery of diagnostic blood tests and performs a lumbar puncture. Jimmie is subsequently diagnosed with measles encephalitis.

Total cost thus far: $7,000

Jimmie continues to have multiple seizures in the ER and ultimately becomes unresponsive. He is critically ill, and the physician determines that emergent intubation is needed to ensure that Jimmie's airway is protected so that he can adequately oxygenate his blood and maintain good oxygen supply to his brain. Jimmie is subsequently admitted to the pediatric intensive care unit (PICU) for further evaluation and monitoring.

Total cost thus far: $10,000

Jimmie stays in the PICU for one week before he is successfully weaned from his breathing tube. He is subsequently moved from the ICU and monitored for three more days as he undergoes recovery therapy.

Total cost thus far: $60,000

You can see how quickly the costs can build up for a single case of a well-known complication of measles. If you apply this on a country-wide scale, as few as 100 similar cases makes the cost a whopping $6,000,000...virtually all of which could have been avoided.

So what could happen if large numbers of people choose not to vaccinate, thereby allowing a resurgence of preventable illnesses?

Insurance companies have to make profits to stay in business, so eventually these additional medical costs will likely be passed down to consumers in the form of increased premiums. Local city/state/federal taxes may also bump to help fund hospitals who care primarily for the uninsured and economically disadvantaged.

Large numbers of people who actively choose not to vaccinate cause the collective whole to bear unnecessary economic damages.

That is, of course, just one reason that the vaccinated care about anti-vaxxers. It's not our primary reason, but from a purely utilitarian standpoint, it's a valid reason as any.

Nota bene:
From a resources perspective, you could extend this example significantly. There are only so many PICU beds in a given city, so each one represents a very scarce resource. If a hospital is forced to spend all of those resources on patients with preventable illnesses, then it cannot help other patients who come in the door. A PICU full of unvaccinated children means there is no room for the victim of child abuse, the child struck by a drunk driver, the infant born 10 weeks early, etc. Think about it.

This answer is not a substitute for professional medical advice. This answer is for general informational purposes only and is not a substitute for professional medical advice. If you think you may have a medical emergency, call your doctor or (in the United States) 911 immediately. Always seek the advice of your doctor before starting or changing treatment. Quora users who provide responses to health-related questions are intended third party beneficiaries with certain rights under Quora's Terms of Use (http://www.quora.com/about/tos). All opinions expressed are solely my own and do not reflect those of any other party. I apologize in advance for any potential errors in this answer, as it is based on my limited knowledge base and even more limited experience. If you spot an error, I ask that you take a moment to teach me, so that my future patients can benefit. Thank you for reading!

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