In response to the ongoing measles outbreak in West Texas, U.S. Health and Human Services Secretary Robert F. Kennedy Jr. has suggested treating patients with vitamin A and cites “good results” from the use of the steroid budesonide, antibiotic clarithromycin, and cod liver oil.
Medical professionals caution that this messaging could undermine initiatives to boost vaccination rates within the population, and misinformation about these treatments is already spreading across online platforms.
Measles, also called rubeola, is a highly contagious viral infection that mainly affects children, but adults can also get infected if they are unvaccinated. It causes fever, cough, runny nose, red eyes, and a characteristic red rash that spreads across the body. It can also lead to serious complications like pneumonia, encephalitis, and death, especially in young children and immunocompromised individuals.
Measles was declared eliminated in the United States in 2000 by the World Health Organization (WHO) due to successful vaccination efforts. There is no specific antiviral treatment to “cure” measles once someone is infected, which is why doctors primarily rely on vaccinations to prevent its spread. Death rates have been falling internationally due to vaccinations, but more than 200,000 people die from the disease a year, most of whom are children.
The WHO recommends two doses of vitamin A supplements, given 24 hours apart to children and adults diagnosed with measles. The U.S. Centers for Disease Control and Prevention (CDC) also recommends vitamin A for “supportive management” of the infection.
Dr. Megan Ranney, dean of the Yale School of Public Health, told CNN, “Vitamin A is not a substitute for vaccination.” Instead, it offers some support against complications from symptoms such as vision loss and pneumonia.
“This restores low vitamin A levels that occur even in well-nourished children. It can help prevent eye damage and blindness. Vitamin A supplements may also reduce the number of measles deaths.”
In a recent opinion piece featured on Fox News on Sunday, Kennedy cited studies indicating that vitamin A has the potential to “dramatically reduce measles mortality.” Then again, in an interview with the network on Tuesday, Kennedy spoke about the benefits of cod liver oil, known for its high levels of vitamins A and D.
However, vitamin A is most effective for measles support in individuals who are already deficient. The cited research studies rely primarily on evidence from low-income countries, where this deficiency is more common. In those cases, the supplements help strengthen the patient’s already weakened immune system. Dr. Adalja, a senior scholar at the Johns Hopkins Center for Health Security, says this distinction is important.
“It’s actually valid information, but it is out of context. Vitamin A supplementation can be lifesaving for measles cases when vitamin A deficiency is present.”
Dr. Peter Hotez, co-director of the Texas Children’s Hospital Center for Vaccine Development and dean of the National School of Tropical Medicine at Baylor College of Medicine, says that in context, the evidence supporting vitamin A use in measles support in the United States is significantly weaker.
“Vitamin A really doesn’t have much of a role in the current discussion on the West Texas measles epidemic because it becomes a distraction about what we really need to focus on, which is vaccinating our kids.”
Kennedy also suggested that the antibiotic clarithromycin may prevent subsequent bacterial infections like pneumonia, although data is lacking. Budesonide is a steroid with a wide range of applications, but it’s unclear how it may benefit someone with measles. Dr. Christina Johns, a pediatric emergency physician at PM Pediatrics in Annapolis, Maryland, told CNN, “It’s really important not to conflate what is supportive or adjunctive care for measles versus curative treatment for measles.”
“There is no treatment for measles. I believe that it is incredibly important to speak very clearly and directly with regard to therapy.”
Last week, the American Academy of Pediatrics released comments to address misconceptions about vitamin A’s ability to prevent measles.
James D. Campbell, M.D., M.S., FAAP, vice chair of COID, cautioned, “Vitamin A, at any dose, does not protect you from measles. No one should take, and no parent should give to their child vitamin A in hopes of preventing measles. It will not do that.”
Vitamin A is considered a micronutrient, which means that only small amounts are required to maintain healthy levels in the body.
“Those small amounts are what is found in a healthy diet and in recommended doses of over-the-counter multivitamin supplements. Larger doses, especially larger doses given over prolonged periods, are very dangerous. In summary, MMR vaccine prevents measles. Vitamin A does not.”
Many doctors, like Dr. Leslie Motheral, a pediatrician in Lubbock, Texas, echoed his comments and insisted parents do not start administering vitamin A to their children as a misguided attempt at prevention. Toxic levels of vitamin A can lead to vomiting, nausea, blurred vision, muscular weakness, liver damage, and possibly brain damage.
“Vitamin A is only recommended in hospitalized patients, and it’s only recommended at specific doses. I want to be very clear with that because I do think there are patients who are not vaccinating and are just giving their kids high doses of vitamin A. As pediatricians, we learn about vitamin A toxicity, but now we’ve got to really make sure we’re watching for those things in these patients.”
Embed from Getty Images
Embed
As of Tuesday, the Texas Department of Health Services reported 159 active cases of measles in West Texas. Gaines County is currently experiencing a significant number of cases, attributed in part to its high population of unvaccinated individuals, including a Mennonite community. Tragically, one unvaccinated child has died, and experts are suggesting that the actual number of cases may be significantly higher than the numbers reported.
Because of the growing outbreak, several residents in Texas have opted to get vaccinated, a decision that experts credit to the availability of reliable information. Dr. Phil Huang, director of health and human services in Dallas County, wrote in an opinion piece in USA Today that officials and medical professionals are doing everything they can to “quickly increase measles vaccination rates in West Texas and surrounding areas—from sending mobile vaccine clinics directly to neighborhoods to partnering with schools to identify and reach out to unvaccinated students and their families.”
“These efforts are working. In recent days, dozens of previously unvaccinated children have received this remarkable protection. Parents are getting vaccine questions answered by medical and public health professionals rather than purveyors of disinformation on social media. And families are getting the peace of mind that vaccines can provide.”
Known for his anti-vaccine sentiments, activism, and the anti-vaccine nonprofit he founded, Kennedy has said little about vaccination in the wake of the outbreak. In his opinion piece on Fox News, he refrained from explicitly endorsing the vaccine, describing the choice to vaccinate as “a personal one” while recognizing its potential role in fostering “community immunity.”
“In highly unvaccinated communities like the Mennonites, it’s something we recommend, but we also understand there is a lot of mistrust of the vaccines.”
However, at his Senate confirmation hearing in January, Kennedy briefly suggested his views on vaccinations had changed.
“I want to make sure the committee is clear about a few things. News reports have claimed that I am anti-vaccine or anti-industry. Well, I am neither; I am pro-safety. All of my kids are vaccinated, and I believe vaccines have a critical role in health care.”
Moumita Basuroychowdhury is a Contributing Reporter at The National Digest. After earning an economics degree at Cornell University, she moved to NYC to pursue her MFA in creative writing. She enjoys reporting on science, business and culture news. You can reach her at moumita.b@thenationaldigest.com.
