Billions Spent Treating Coloradans for Vaccine-Preventable Diseases While Vaccine Uptake Continues to be Low

February 27, 2023

Hospital treatment for vaccine-preventable diseases in 2020 and 2021 resulted in a combined $13 billion in healthcare charges. The COVID-19 pandemic fueled an initial drop in routine childhood immunizations, but rates continue to lag even as normalcy returns.

AURORA, Colo. – From 2020 to 2021, there were over $13 billion in healthcare charges to treat vaccine-preventable diseases (VPDs) like measles, flu and whooping cough in Colorado adults and children. In the two-year span, there were more than 420,000 hospitalizations and emergency department (ED) visits for VPDs. That is according to a report jointly released by Children’s Hospital Colorado (Children’s Colorado) and Immunize Colorado.

The Vaccine-Preventable Diseases (VPD) Report shows that in 2020 and 2021, over 327,000 Colorado adults and nearly 50,000 Colorado children were hospitalized or visited an ED with a VPD. Most adult hospitalizations were due to COVID-19, followed by influenza, varicella and pneumococcal disease; most hospitalizations in children were due to influenza, COVID-19 and pneumococcal disease. (The report acknowledges that COVID-19 vaccines were not widely available in 2020 and therefore COVID-19 was not yet considered vaccine-preventable.)

The VPD Report, prepared by researchers in the Department of Epidemiology at Children’s Colorado, examines CDC National Immunization Survey data and 2020 and 2021 Colorado Hospital Association inpatient and emergency department data to determine the health and economic burdens resulting from VPDs in Colorado. According to the report, the economic toll of VPDs for publicly insured and uninsured children is nearly double that for commercially insured children and more than double for publicly insured and uninsured adults. Hospitalizations and ED visit charges for publicly insured and uninsured Coloradans (adults and children) totaled over $5 billion in 2020 and $4 billion in 2021.

The report notes that childhood vaccination rates for routinely recommended vaccines remain low compared to pre-pandemic levels. In fact, only 71% of Colorado children born in 2018 were fully vaccinated with the CDC’s recommended 7-series of routine vaccines by age two, ranking Colorado 32nd in the nation. This is far below the Healthy People 2020 goal of 90%. Since 2020, COVID-19 has been a top ten cause of death among children in the U.S.—despite their being at lower risk for severe disease compared to adults—and COVID-19 vaccination rates in young children remain very low.

“Pediatric hospitalizations and ED visits are typically highest in the first three years of life when children are not yet fully vaccinated and protected,” said Dr. Jessica Cataldi, the report’s main author and infectious diseases pediatrician at Children’s Hospital Colorado. “It’s critical to make sure young children are up-to-date with vaccinations.”

The report’s findings are consistent with trends in national vaccine uptake. On January 13, 2023, the CDC released data which shows at least 250,000 U.S. kindergartners are not protected against measles. The report acknowledges that measles cases are increasing worldwide. Measles is extremely contagious and children under 5 are particularly susceptible to complications from infection. Data from the Colorado Department of Public Health and Environment (CDPHE) show that in 2021 only 94.4% of pre-k to 12th grade students were fully vaccinated against measles. Infants too young to be vaccinated and people with conditions for which the MMR vaccine is contraindicated rely on a 95% community immunity threshold to keep them safe.

The VPD Report also spotlights concern around human papillomavirus (HPV)-related ED visits in Colorado’s adult population. HPV infection can cause oropharyngeal, cervical and anogenital cancers. There were $80-95 million in charges per year in 2020 to 2021 to treat HPV-associated illness. Four out of five people will get HPV at some point in their lives, and the HPV vaccine can prevent more than 90% of HPV-related cancers from developing. Yet according to CDPHE, only 51% of 13-17-year olds have initiated the HPV vaccine series and only 37% have completed it. These rates are far below the Healthy People 2030 goal of 80% HPV vaccination coverage. 

While VPDs take a toll on Coloradans’ pocketbooks, the impact on individual health, public health and the healthcare system are also a major concern. “Vaccinations are critical for the wellbeing of all Coloradans throughout their lives. Under-vaccination not only impacts individual health and creates community risk for disease outbreaks, but adds additional strain on our public health and healthcare systems,” said Dr. Cataldi. “As healthcare providers, we should check immunization records for every patient at every visit to make sure those in our care are adequately protected.”

Access the full Vaccine-Preventable Diseases report.


Immunize Colorado is a statewide, independent 501(c)(3) nonprofit. Its mission is to protect Colorado families, schools and communities from vaccine-preventable diseases. Immunize Colorado does not accept funding from vaccine manufacturers or distributors. To learn more, visit and connect with Immunize Colorado on Facebook and Twitter.


Children’s Hospital Colorado is one of the nation’s leading and most expansive nonprofit pediatric healthcare systems with a mission to improve the health of children through patient care, education, research and advocacy. Founded in 1908 and recognized as a top 10 children’s hospital by U.S. News & World Report, Children’s Colorado has established itself as a pioneer in the discovery of innovative and groundbreaking treatments that are shaping the future of pediatric healthcare worldwide. Children’s Colorado offers a full spectrum of family-centered care at its urgent, emergency and specialty care locations throughout Colorado, including an academic medical center on the Anschutz Medical Campus in Aurora, hospitals in Colorado Springs, Highlands Ranch and Broomfield, and outreach clinics across the region. For more information, visit or connect with us on FacebookTwitterInstagram and YouTube.  

Children’s Hospital Colorado complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex.

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