Amid a growing measles outbreak, doctors worry RFK is sending the wrong message

Two people have now died in the growing measles outbreak in west Texas and New Mexico.

New Mexico Health officials on Thursday confirmed the death of an unvaccinated adult who tested positive for measles. The first death was a school-age child in Gaines County, Texas last week.

News of a second death comes as infectious disease doctors worry that the federal government’s messaging about the outbreak is putting more emphasis on treatments like vitamin A than on vaccination, even as misinformation about some of these treatments is spreading online.

Those concerns come in the wake of recent comments made by Health and Human Services Secretary Robert F. Kennedy Jr. Kennedy addressed the growing measles outbreak in an editorial for FOX News published on Sunday, also posted on the HHS website.

While mentioning the value of vaccination for community immunity, Kennedy said “the decision to vaccinate is a personal one.” He emphasized treatment for measles, saying that vitamin A can “dramatically” reduce deaths from the disease. In an interview with FOX News Tuesday, he said Texas doctors are giving steroids and cod liver oil to their measles patients and “getting very, very, good results.”

In his editorial, he said good nutrition is “a best defense against most chronic and infectious illnesses.”

That emphasis on nutrition and vitamin A to treat measles is concerning some infectious disease doctors.

“Mentions of cod liver oil and vitamins [are] just distracting people away from what the single message should be, which is to increase the vaccination rate, ” said Dr. Amesh Adalja, an infectious disease physician and senior scholar with the Johns Hopkins Center for Health Security.

While vitamin A can play a role in preventing severe disease, discussion of vitamins, “doesn’t replace the fact that measles is a preventable disease. And really, the way to deal with a measles outbreak is to vaccinate people against measles,” says Dr. Adam Ratner, a member of the infectious disease committee of the American Academy of Pediatrics.

Kennedy did acknowledge that measles is highly contagious and that it poses health risks, especially to people who are not vaccinated. He said vaccines not only protect individual children from measles, but also protect people who can’t be vaccinated. But he didn’t strongly encourage people to get their children vaccinated — which is usually a key part of the public health response during an outbreak.

In 2019, when a measles outbreak was raging in the U.S., then health secretary Alex Azar came out with a statement strongly supporting vaccination and warning of the risks of under-vaccination.

When it comes to vitamin A, studies conducted decades ago in low and middle-income countries found that the vitamin can reduce the risk of severe disease and death, in children who are malnourished and have vitamin deficiencies, says Adalja.

There’s also evidence that, even in the absence of a pre-existing deficiency, measles seems to deplete the body’s stores of vitamin A. Both the World Health Organization and the American Academy of Pediatrics recommend giving two doses of vitamin A to children who have the disease, especially if they are so sick they are hospitalized.

But, Ratner stresses that vitamin A does not prevent measles.

A false idea circulating online is that giving children high doses over long periods of time can prevent measles, says Ratner. He says that’s not only wrong but can be quite dangerous.

“Vitamin A can accumulate in the body,” he says. “It can be toxic to the liver. It can have effects that you don’t want for your child,” like liver damage, fatigue, hair loss and headaches. Ratner works as a pediatric infectious disease specialist in New York City. He says that similar misinformation about vitamin A made the rounds during the city’s measles outbreak in 2019.

Scott Weaver, director of the Institute for Human Infections and Immunity at the University of Texas Medical Branch, says he worries people might look at a vitamin bottle and think, “Well, maybe if I take two or three times this amount, I’ll be even better protected against measles.“

“I’m concerned that people think that vitamin A or other nutrition is a substitute for vaccination to prevent infection and to prevent spread,” Weaver says.

In his Fox News interview, Kennedy said Texas doctors are “getting very, very, good results.” with a mix of treatments including steroids and cod liver oil. NPR has not confirmed the use of cod liver oil in Texas, but Adalja says, “there’s no data that cod liver oil is going to have any benefit on measles.”

And because cod liver oil is so high in vitamin A, Ratner worries parents could end up giving their children too much – potentially toxic amounts.

Adalja would have liked Kennedy to emphasize that vaccines are the best defense against measles.

“Then you don’t even have to think about treatment, because when it comes to an infectious disease, prevention is always better than treatment,” he says.