• 1960s, 3 to 4 million cases annually
    • 500 reported deaths per year
    • Medical expenditure
    • Work time loss for parents taking care of kids with measles
  • 1963, measles vaccine with booster doses to reimmunize timely
    • Fewer than 3,000 cases per year and very few deaths

But during the period, 1989 to 1991 a huge resurgence took place (50,000 cases and 123 deaths)

  • Disadvantages inner-city youth, low immunization
  • Unimmunized children caused Negative Externality on other children for whom immunization wore off.

Federal government reacted:

  • Encouraged parents to get kids vaccined
  • Paid for the vaccines for low-incomed families
  • Immunization rates rose to 90% (from 70% before the epidemic)
  • Finally, only 300 confirmed cases by 1995.