The measles outbreak that originated in Gaines County, Texas, has continued to spread with 481 cases identified since late January, almost all of them in unvaccinated individuals. In all, 56 of those patients have been hospitalized and two children — girls aged 6 years and 8 years — have died from the disease. The rise in cases is troubling as the new Secretary of Health and Human Services (HHS) Robert F. Kennedy Jr (RFK) is well known for espousing views that question the safety and utility of vaccines.
In an interview earlier this year, RFK appeared on Fox Nation to talk about a range of issues, but he spent much of the time discussing infectious diseases and the measles outbreak in particular. We took a closer look at the secretary’s comments quoted in his own words and fact-checked them with some leading infectious disease specialists.
RFK: “The safest application of vitamin A is through cod liver oil because you’re getting it through food and the toxicity issue is no longer an issue. You can test people at the hospital for vitamin A.…There’s a lot of good studies out there to show that even as a prophylaxis it’s effective in early treatment.”
Vitamin A is a micronutrient that enhances immune function and cod liver oil is high in vitamin A. Research conducted over several decades has shown that while vitamin A may be helpful in some cases for the treatment of measles, it is not a substitute for vaccination. And cod liver oil should not be used as a source of vitamin A because it would be highly impractical due to the high volume that would need to be ingested to obtain a therapeutic dose of the nutrient, which is 200,000 international units given over two consecutive days.
“In order to get enough cod liver oil to reach that amount you would have to ingest 45 teaspoons of cod liver oil per day for 2 days,” said Paul A. Offit, MD, director of the Vaccine Education Center and an attending physician in the Division of Infectious Diseases at Children’s Hospital of Philadelphia, Philadelphia.
Patrick E. Jackson, MD, an assistant professor in the Division of Infectious Diseases and International Health at the University of Virginia, Charlottesville, Virginia, agrees that cod liver oil is not a viable option for the treatment of measles.
“We would generally use a high dose and a known dose of vitamin A at least in the developing world to treat measles” where access to vaccination is limited, Jackson said. But you wouldn’t use cod liver oil. “It’s important that the dose be tested and consistent because too much vitamin A is toxic.” Consuming excessive vitamin A can lead to a condition called hypervitaminosis A, which can lead to blurred vision and liver damage.
RFK: “There is malnutrition in West Texas, in Gaines County, and in the Mennonite community. The doctors that I’m talking to on the ground, the leaders in the community are reporting that the people who are getting sick are people who are umm and the little girl who died, where malnutrition may have been an issue in her death. There’s a lot of poverty in that area and the food is kind of a food desert. The best thing that Americans can do is to keep themselves healthy. It’s very very difficult for measles to kill a healthy person.”
The 6-year-old girl who died from the measles in Gaines County was healthy before she contracted the measles, so recommending a healthy diet in lieu of vaccination is both misleading and dangerous, Offit said.
“[RFK Jr] is of the false belief that if your nutrition is good, you cannot die from the measles. I have no idea where he gets this,” Offit said. “Measles killed 500 children a year before there was vaccination and most of those children were previously healthy.”
Jackson, of the University of Virginia, said even if someone was primarily concerned with their own health and not the broader public interest, vaccination still would be the best option. “In the pre-vaccine era, measles was responsible for about 50% of infectious disease deaths in children, so we know that it’s very capable of killing people,” he said.
RFK: “We also understand that there’s a lot of mistrust of the vaccines in [the Mennonite community in Gaines County, Texas]. One of the consistent themes was that the Mennonites have told me and their leaders is there’s a number of vaccine-injured kids, about a dozen of them in that community.”
This comment about vaccine injuries is not supported by the known science about the safety of the measles, mumps, rubella (MMR) vaccine, said David M. Higgins, MD, a pediatrician at the University of Colorado and Children’s Hospital Colorado, Aurora, Colorado. “I haven’t seen any credible evidence to show that there were ‘vaccine-injured’ patients in Gaines County,” Higgins said.
Glenn Fennelly, MD, an expert in pediatric infectious diseases with Doctors of the World, an international human rights organization, agreed. “Given what’s known about the safety of the vaccine, it’s highly improbable that there would be such a cluster of vaccine injury,” Fennelly said.
The MMR vaccine is considered safe with common side effects that include a sore arm, fever, mild rash, and temporary stiffness in the joints. MMR can cause rare reactions in some patients, including a risk for febrile seizure in about 2 in 10,000 patients. Globally, more than 500 million doses of MMR vaccine have been given in over 90 countries in the past three decades.
One in 40,000 vaccinated children may develop immune thrombocytopenic purpura, a disorder that decreases the body’s ability to stop bleeding and which can occur after a natural measles infection or after an MMR vaccination. A systematic review of 338 studies published in the June 2021 issue of Vaccine found no link between the MMR vaccine and autism.
RFK: If you are healthy, it’s almost impossible for you to be killed by an infectious disease in modern times because we have nutrition, because we have access to medicines. It’s very, very difficult for any infectious disease to kill a healthy human being.
In 2019, 13.7 million people died globally from infectious disease and 3 million of those deaths were in children younger than 5 years, according to the March 2022 issue of The Lancet, Global Health. In 2023, COVID-19 alone contributed to 76,446 deaths in the United States. Each year an estimated 12,000-52,000 people die from influenza in this country, depending on the severity of the flu season, according to the Centers for Disease Control and Prevention.
Infectious diseases remain a threat to healthy individuals, even with modern healthcare and a healthy diet. And if you contract measles, your likelihood of hospitalization is 1 in 5.
“Across the board, it’s 1 in 5 and in all cases of the measles 1 in 20 will get pneumonia, which is the major cause of death,” Fennelly said. “The virus itself is immunosuppressant, which knocks down our normal T- and B-cell responses, which can make an individual vulnerable to bacterial superinfection.”
Even in modern times infectious disease can still take a deadly toll, and without vaccinations, those numbers would be far worse. It’s just not a risk worth taking. “Healthy people die everyday from infectious diseases,” Higgins said.
Sara Novak is a science journalist based in South Carolina. She’s a contributing writer for Discover Magazine and her work has appeared in The New York Times, Scientific American, National Geographic, New Scientist, and many other publications. She has a master’s degree in science writing from Johns Hopkins University and a bachelor’s degree in journalism from the University of Georgia.