Fact Check: RFK Jr. misleads on vitamin A, unsupported therapies for measles
In the midst of a growing measles outbreak in Texas that has killed one child, Health and Human Services Secretary Robert F. Kennedy Jr. has misleadingly focused on vitamin A, including from cod liver oil, and two non-standard medications as treatments for measles.
Vitamin A is recommended around the world for measles because there is evidence it can help if someone is deficient, but the benefit to patients in the U.S. is unclear. Cod liver oil, which contains vitamin A, isn’t advised at all for measles — and would need to be consumed in a potentially dangerous amount to get the recommended dosage of the vitamin used during an infection.
The other medications Kennedy has discussed, a steroid and an antibiotic, aren’t specific treatments for measles, experts told us. Neither vitamin A nor these medications replace vaccination, which is safe and effective in preventing the highly contagious disease.
Kennedy made his remarks in an interview with Fox News medical correspondent Dr. Marc Siegel. Snippets of the interview were featured in four Fox News or Fox Business segments airing on March 4.
“They have treated most of the patients, actually, over 108 patients in the last 48 hours. And they’re getting very, very good results, they report from budesonide, which is a steroid, it’s a 30-year-old steroid,” Kennedy said in the longest of the segments. “And clarithromycin [an antibiotic] and also cod liver oil, which has high concentrations of vitamin A and vitamin D.”
Robert F. Kennedy Jr. was confirmed by the Senate as the Secretary of Health and Human Services on Thursday.
“We need to look at those therapies and other therapies,” Kennedy said in another segment. “We need to really do a good job of talking to the front-line doctors and see what is working on the ground, because those therapeutics have really been ignored by the agency for a long, long time.”
In each segment, Kennedy either referred to the importance of vaccination in some way or Siegel paraphrased Kennedy making such remarks. That’s a change for Kennedy, who has spread falsehoods about vaccines for 20 years and in a 2021 book wrote that measles outbreaks “have been fabricated to create fear.” But in each of the Fox clips he also emphasized personal choice or included statements that could undermine vaccine confidence.
“The CDC in the past has not done a good job at quantifying the risk of vaccines — we are going to do that now,“ Kennedy said during a segment featured on Bret Baier’s “Special Report.”
“The best thing that Americans can do is to keep themselves healthy,” Kennedy said in the full interview, which is available on Fox Nation, the network’s subscription service. “It’s very, very difficult for measles to kill a healthy person.”
The Texas Department of State Health Services has said that the school-aged child who died from measles “was not vaccinated and had no known underlying conditions.” As of March 7, there have been 198 cases associated with the outbreak, including 23 hospitalizations. Another 30 measles cases, which are suspected to be related to the outbreak, have been reported in New Mexico. One of those individuals, an unvaccinated adult who did not seek medical attention, died, although the official cause of death isn’t yet known.
Kennedy’s interview follows an editorial he penned for Fox News on March 2, which discussed vaccination but also emphasized vitamin A and called good nutrition “a best defense against most chronic and infectious illnesses.” For many diseases for which there are vaccines, vaccines are the best defense, as they are the only way of providing specific immunity against a pathogen.
The opinion piece was notable in that it was seemingly Kennedy’s strongest endorsement of vaccination to date. A subheading called the measles, mumps and rubella, or MMR, vaccine “crucial” and Kennedy wrote that “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.” But the piece did not explicitly say the MMR vaccine is safe, nor did it specifically advocate vaccination. Instead, Kennedy urged parents “to consult with their healthcare providers to understand their options to get the MMR vaccine,” calling the decision to vaccinate “a personal one.”
On Feb. 26, as we’ve written, Kennedy downplayed the Texas outbreak, saying it was “not unusual,” and falsely stating that hospitalizations had occurred “mainly for quarantine.”
Sen. Michael Bennet, D-Colo., questioned Robert F. Kennedy Jr. about flip-flopping views on healthcare issues during his Senate confirmation hearing on Wednesday.
Vitamin A
Vitamin A is recommended for people who contract measles. People who are vitamin A-deficient tend to have worse measles outcomes, and studies in lower-income countries where many people lack the vitamin have shown that certain high-dose bursts of vitamin A help reduce measles mortality.
A 2005 Cochrane review, for example, found that when pooling the results of three studies conducted in Africa, two large doses of vitamin A given on consecutive days — the standard protocol for supplementation in measles cases — to children younger than 2 reduced deaths by about 80%.
But few studies exist for populations without vitamin A deficiencies, so it’s not known if supplementation improves measles outcomes in countries like the U.S.
A 1999 study of 105 children in Japan found that measles patients given vitamin A did not develop pneumonia less frequently, but they coughed and had a fever for a shorter period than those not given the supplement. A similarly sized 2021 study of children admitted to the hospital for measles in Italy found no differences in a variety of symptoms or complications in kids given vitamin A compared with those who were not.
Given that it’s possible that some people in higher-income countries might have a deficiency, and because measles itself can lower vitamin A levels, the World Health Organization recommends that all measles patients receive vitamin A, regardless of where they live.
“I think it’s somewhat of a 50-50 chance of, you know, whether it actually supports somebody’s overall health and recovery” when they don’t have a deficiency, Dr. Michael Mina, an infectious disease expert who previously was a professor at Harvard School of Public Health, told us in a phone interview.
All of this context was missing when Kennedy wrote in his editorial, “Studies have found that vitamin A can dramatically reduce measles mortality.”
Similar to the Cochrane review, the meta-analysis Kennedy cited found that at least two doses of vitamin A cut measles mortality by 62%, as measured by the same three studies in Africa. The paper, notably, also concluded that a single measles vaccination reduced measles disease by 85%.
Some experts are concerned that Kennedy’s messaging on vitamin A could lead people to incorrectly assume the vitamin is so effective that they don’t need to get vaccinated.
Adm. Brett Giroir, the former coronavirus testing czar who served in various other health capacities during President Donald Trump’s first term and is temporarily advising Kennedy on infectious diseases, wrote on X, “please do not rely on #VitaminA to save your child in the US – helps in Africa where there is deficiency-not here.”
“No one should take, and no one should give to their child, vitamin A in the hopes it will prevent measles,” Dr. Sean O’Leary, chair of the American Academy of Pediatrics Committee on Infectious Diseases, told us in a statement.
“There’s a time and place for talking about nutritional status and vitamin administration. It’s just so much more important to prevent measles in the first place through vaccination,” Mina said.
Vaccination, Mina said, uses “the natural processes of your body … to be your first line of defense — way before you have to deal with vitamin A because your kid is sick.”
Unsupported Therapies
As for Kennedy’s claims about measles patients in Texas getting “very, very good results” with cod liver oil, clarithromycin and budesonide, experts said none of them are specific treatments for measles. They aren’t supported by evidence, and in some cases could be dangerous.
“Cod liver oil has vitamins A and D but is not something we recommend for measles,” O’Leary said in his statement.
The problem with using cod liver oil for measles is that even assuming vitamin A works for a patient, it would be very difficult to consume enough oil to reach the recommended dosage of the vitamin — and that much oil could itself be a problem.
“It’s not a reasonable suggestion,” Mina said. “It’s damaging because it’s misleading, and I would argue it’s harmful.”
For measles, vitamin A should be given in two very large daily doses, with a third dose several weeks later if a child appears to be vitamin A-deficient, according to the World Health Organization. Because vitamin A is fat soluble, it’s possible to take too much of the vitamin, so guidelines call for consulting with a doctor about dosage.
Clarithromycin might be used if a person with measles developed a secondary bacterial infection, but O’Leary said it would “not be a first line choice” antibiotic for such an infection.
As several physicians wrote in a 2019 feature on measles in the New England Journal of Medicine, “Antibiotics, in the absence of pneumonia, sepsis, or other signs of a secondary bacterial complication, are generally not recommended.”
“Budesonide is generally used as an inhaled steroid for things like asthma and is not a recommended treatment for measles,” O’Leary said.
Mina said it’s possible that the steroid could be used in a nebulizer for a hospitalized patient who’s in respiratory distress. But again, the drug would be treating the symptoms, not the measles disease.
“I just don’t know where that came from,” he said of Kennedy’s comment on use of the steroid.
Budesonide, notably, can suppress the immune system. Patients taking the drug are sometimes told to be particularly careful to avoid measles exposures, as they could be more susceptible to a serious measles infection.
The editing of the longest Fox segment suggests that Kennedy was saying that the Centers for Disease Control and Prevention was providing the alternative treatments, but a review of the full interview shows Kennedy was speaking of two Texas physicians.
One, Dr. Richard Bartlett, previously claimed that budesonide was a “silver bullet” for COVID-19 and suggested it worked so well that there was no need for a COVID-19 vaccine. He also gave COVID-19 patients clarithromycin. In 2003, he was subject to disciplinary action by the Texas State Board of Medical Examiners for allegations of inappropriate prescribing of medically unnecessary tests and medicines, including antibiotics and steroids.
The other doctor, Dr. Ben Edwards (Kennedy referred to him as “Ed Benjamin”), has been featured in an article on the website of Children’s Health Defense, the antivaccine nonprofit that Kennedy founded and directed prior to becoming health secretary.
In the full interview, Kennedy said the two doctors were “seeing what they describe as almost miraculous and instantaneous recovery” using the alternative therapies, adding that “we haven’t done a clinical trial on those and we should have, but we haven’t. And we’re going to.”
When we asked whether the CDC endorses the use of the therapies Kennedy mentioned, a spokesperson said the agency “continues to recommend the MMR vaccine as the best way to prevent measles” and that medical care for measles is supportive, “to help relieve symptoms and address complications.” Vitamin A “may be appropriate under the direction of a physician,” the spokesperson added, sharing the agency’s webpage that includes usage recommendations for the vitamin. The webpage does not include any mention of cod liver oil.
A spokesperson for Covenant Children’s Hospital in Lubbock, which has treated many of the measles patients in the Texas outbreak, said the hospital “can’t comment specifically about the care of our patients” but that its doctors “have followed recommended treatment protocols for patients with measles.”
The Texas Department of State Health Services directed us to HHS, but said that it “has not recommended any of those treatments.” HHS did not reply to a request for comment.
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