RFK Jr. touts vitamin A for measles prevention. Doctors disagree.
Late last month, the U.S. had its first death from measles in a decade when a school-aged child died in Texas, the epicenter of a current outbreak.
The child, whom the Texas Department of State Health Services (DSHS) said had no underlying condition, was unvaccinated.
Measles is a vaccine-preventable disease that was formerly eradicated in the U.S. in 2000. The vaccine is usually given early in childhood as the standard set of immunizations required to attend school.
Newly-appointed Secretary of the U.S. Department of Health and Human Services (HHS) Robert F. Kennedy Jr., who has a history of pushing anti-vaccine sentiments, has since urged parents to consider vaccination. He has also, however, touted other measures of prevention and treatment that doctors and health experts say are not medically or scientifically sound.
RFK Jr., who has no formal medical training, has cited vitamin A and cod liver oil as effective methods of measles prevention while stopping short of outright suggesting vaccines, the only proven method of preventing measles at a rate of 97% efficacy, according to the CDC.
Here's a look at what RFK has said and why doctors are urging patients not to lean on these methods.
What has RFK said about vaccines, vitamin A and measles?
Days after the first measles death since 2015 was announced, RFK Jr. published an opinion piece on Fox News Digital calling the outbreak a "call to action," but did not go as far as explicitly suggesting vaccination.
"The decision to vaccinate is a personal one," Kennedy wrote. "Vaccines not only protect individual children from measles, but also contribute to community immunity, protecting those who are unable to be vaccinated due to medical reasons."
The Fox Digital op-ed said the Centers for Disease Control (CDC) had released new guidance supporting vitamin A as a treatment for measles. It likewise claimed diet is the "best defense against most chronic and infectious illnesses."
In another Fox News interview, RFK, the founder of the anti-vaccine group Children's Health Defense, suggested cod liver oil as a treatment for measles.
Public health officials and doctors have cried foul, saying there is no evidence to support these claims, instead emphasizing the importance of vaccination.
In the U.S., the measles vaccine is usually given not alone but in combination with the mumps and rubella vaccines, called the MMR vaccines. Typically, children receive MMR vaccines as part of the regular course between the ages of 12 and 15 months for the first dose and ages 4 to 6 for the second. The vaccine protects against measles, mumps, and rubella and is 97% effective at preventing measles when both doses are given and 93% after only one dose.
What experts say about the use of vitamin A to treat or prevent measles
While RFK cited recent CDC guidance for the use of vitamin A in treating and preventing measles, the notice itself states that "vaccination remains the best defense against measles infection" and that the disease "does not have a specific antiviral treatment."
Likewise, it mentioned vitamin A only as "supportive care" that "may be appropriate" if administered under the direction of a physician.
The use of vitamin A is linked to measles in that it is sometimes recommended for use in infected patients, especially children, who are already malnourished or nutrient deficient, according to the World Health Organization (WHO).
Because measles can reduce the amount of vitamin A in the body, children who are already lacking it due to improper nutrition can be at higher risk for more severe complications, including death. Vitamin A may help shorten the course of illness in people who are acutely ill and already suffer a deficiency. However, there is no proof that it can otherwise aid in recovery from or prevent the spread of measles in any capacity, experts say.
Dr. Christopher R. Sudfeld, Associate Professor of Global Health and Nutrition at Harvard T.H. Chan School of Public Health and author of the vitamin A study cited by RFK in his op-ed, told Paste BN the study found vitamin A treatment can be beneficial in places where vitamin A deficiency is highly prevalent, but this deficiency is very uncommon in the U.S. today.
"Evidence on vitamin A treatment should not be extended to prevention. Vitamin A supplements will not prevent people from getting measles, vaccination does that," he added.
"Vitamin A will reduce measles mortality, and this is especially in low-to middle-income, resource-limited countries where vitamin A deficiency and malnutrition is very common," Dr. Tina Tan, president of the Infectious Diseases Society of America and a professor at Northwestern University Feinberg University School of Medicine, said during a briefing on Tuesday. However, "in persons that are not malnourished, studies have actually shown that vitamin A really has no effect," she added.
Plus, "I would not expect to see much benefit in a U.S. setting where the majority of children have ample vitamin A in their diets, and the guidance also cautions about the dangers of overdosing (i.e., parents should not be supplementing on their own)," Dr. Daniel R. Kuritzkes, Chief of the Division of Infectious Diseases at Harvard Medical School, told Paste BN.
You can overdose on vitamin A, doctors warn
Dr. Ron Cook, a physician practicing in Lubbock, Texas, and professor of family medicine and medical education at Texas Tech University, reiterated the potential dangers of at-home dosing with vitamin A at a Feb. 28 press conference.
"Most people are nutritionally complete if they eat a regular diet," he said, adding that most people in the U.S. already have normal vitamin A levels. "You can easily overdose on vitamin A. There are plenty of cases of toxicity."
Vitamin A is a fat-soluble vitamin, he said, meaning it "lives" in the fat of your body once ingested and stays in your system. This is compared to water-soluble vitamins, like vitamin C, which are not stored in the body and therefore allow excess amounts to pass through urine.
"We just can't pee it off," he said. "So when you give those big doses, that could cause lots of problems, and we need to save that for those (sick) individuals and let the health care providers in the hospital that are taking care of those individuals deem whether or not it's necessary to treat measles."
Vitamin A toxicity can cause symptoms including nausea, vomiting, diarrhea, joint pain, bone pain, fatigue, skin changes, liver damage, blurred vision and increased intracranial pressure, warned Tan. In children, it can cause developmental problems and other types of neurological defects.
"Vitamin A is recommended for children diagnosed with measles to help prevent complications, particularly in children who are hospitalized,” Dr. Sean T. O’Leary, chair of the American Academy of Pediatrics Committee on Infectious Diseases, said in a statement. "It should not be used to try to prevent measles, and high doses of vitamin A are potentially very harmful. The only effective way to prevent measles is the MMR vaccine."