Dr. Richard Pan, Los Angeles Public Health Officials, and Coalition of Community Advocates Release Data on Economic Impact of Measles Outbreaks and Cost to California Taxpayers

May 10, 2019

SACRAMENTO – Dr. Richard Pan, a pediatrician and state senator representing the Sacramento region, was joined today at University of California, Los Angeles (UCLA) by Dr. Jan King, Regional Health Officer for West and South Los Angeles, and a coalition of doctors, faith leaders and parents to highlight the health and economic consequences of recent measles cases throughout the state. Dr. Pan and the public health officials detailed efforts by California counties to contain the spread of measles, released county-specific data on the associated costs, and urged California legislators to pass Senate Bill 276 to rein in bogus medical exemptions and protect community immunity.

“A few unethical doctors are putting children at-risk for disease while profiting from selling inappropriate medical exemptions to misinformed parents.  The lack of community immunity at schools with students granted inappropriate medical exemptions has contributed to the spread of preventable diseases such as measles,” said Dr. Richard Pan. “The infection of 44 people with measles in California are not only a threat to the safety and health of our children, these infections are disruptive and costly to taxpayers.  More than 1000 students and staff were quarantined for measles exposure in Los Angeles with costs to be determined; however, the costs associated with containing just exposures from three measles cases at Los Angeles International Airport earlier this year have already cost county taxpayers more than $80,000.

The California Department of Public Health has just started to ask counties to track activities and costs counties are undertaking with and without current measles cases. To gain a better understanding of the costs that counties have incurred, we asked counties for their preliminary estimates. Figures received so far are attached. 

Activities/costs incurred by counties with measles cases include: Case investigation and contact tracing including the number of contacts, laboratory testing, developing reports, guidance documents, isolation or quarantine, work with providers, any other actions taken to stop the spread of the outbreak, time spent in meetings and conference calls and media response. 

Activities/costs incurred by counties with no measles cases include: conference calls or meetings, report review, response to stakeholders, public and media questions related to measles and guidance document development.

Dr. Pan and Dr. King were joined at the UCLA press conference by Dr. Sion Roy, Incoming President of the Los Angeles County Medical Association (LACMA); Erin Richardson, a local parent; Rabbi Hershy Z. Ten, President, Bikur Cholim; Dr. Alice Kuo, Professor of Internal Medicine and Pediatrics at the David Geffen School of Medicine at UCLA; and Dr. Valencia Walker, Pediatrician and Chair, California Medical Association (CMA) Council on Legislation.

Measles was declared eradicated in the United States in 2000, but already in 2019 there have been 44 cases of measles reported in California. There were 21 confirmed cases of measles in California in all of 2018. UCLA was the site of a quarantine late last month in which students, faculty and staff were told to stay home because they might have come in contact with a measles patient. 

In 2015, Dr. Pan authored Senate Bill 277 (SB 277) which abolished personal belief exemptions to school-required vaccinations in California, leaving the medical exemption process intact. As a result of the implementation of SB 277, overall vaccination rates increased significantly to more than 95 percent statewide. That is greater than the 94 percent vaccination rate necessary to achieve community immunity and prevent the spread of a measles outbreak. Despite this success, however, California also experienced a dramatic increase in the number of medical exemptions, from 0.2% in 2015-16 to 0.7% in 2017-18, according to California Department of Public Health (CDPH) data.

Because some doctors are selling medical exemptions in a way to personally profit from their sale, Dr. Pan is authoring SB 276 to strengthen the medical exemption process and protect communities from the spread of vaccine-preventable diseases such as measles. Under Senate Bill 276, the California Department of Public Health will grant medical exemptions. Physicians will submit information to CDPH, including the reason for the exemption, the physician’s name, and license number, and they will certify that they have examined the patients. Senate Bill 276 is co-sponsored by the California Medical Association, the American Academy of Pediatrics, California, and Vaccinate California.




Dr. Richard Pan is a parent, small business owner, former UC Davis educator and pediatrician who represents Sacramento, West Sacramento, Elk Grove and unincorporated areas of Sacramento County in the state legislature and is the Chair of the Senate Health Committee. As a legislator, Dr. Pan continues to practice medicine at WellSpace Health Oak Park Community Clinic, pursuing his passion for working with families to build healthier communities.


Appendix: Total Reported Measles Cases in California in 2019 and County-Specific Costs Associated with 2019 Measles Outbreaks


Reported Measles Cases[1]

Estimated Costs of Some or All Reported Cases [2]










Los Angeles



(Cost is only for 3 cases at Los Angeles International Airport)










San Francisco



San Mateo



Santa Clara



Santa Cruz






Other (Calaveras, Shasta, Tehama)






(not inclusive of all measles cases in state)



[1] Source: California Department of Public Health (CDPH), accessed May 9, 2019: https://www.cdph.ca.gov/Programs/CID/DCDC/Pages/Immunization/measles.aspx 

[2] Source: County health data.

[3] Costs include monitoring and distributing educational information to clinics.

[4] Figure includes only personnel costs for public health department and most affected hospital. Does not include medications, lab tests or additional vaccine supply; costs to other health care facilities; or lost staff time from providers excluded from work due to outbreak.

[5] Nearly all of the costs associated with the response to these three cases come from the approximately 760 staff hours spent by epidemiologists, public health nurses, and other staff in case contact investigations, tracking, follow-up, and communications.

[6] Estimate includes regular staff time, overtime pay, symptom monitoring and management. Does not include hospital costs.

[7] Personnel costs and staff time.

[8] Includes personnel costs, lab tests, and communications materials.

[9] Includes school and public health personnel and resources.