Robert F. Kennedy Jr.’s hesitant response to the Texas measles outbreak — hinting that vaccination is important, but never fully embracing it — has left many experts wondering: Does the nation’s top health official support vaccines or not?
Kennedy, the Health and Human Services Secretary, wrote in an editorial published by Fox News on Sunday, that the measles-mumps-rubella (MMR) vaccine “is crucial to avoiding potentially deadly disease.”
Behind the scenes, however, Kennedy, a vocal, longtime vaccine skeptic, appears to be taking steps to minimizing the importance of vaccination. Under his leadership, two meetings to discuss next steps for vaccines were canceled. And he’s “collecting names of potential new members to put on a committee that recommends which vaccines Americans should get and when, according to people familiar with the matter,” The Wall Street Journal reported Tuesday.
As of Tuesday, 159 measles cases had been confirmed in Texas. Most of the sick people, including a young child who died, hadn’t been vaccinated against the virus.
Kennedy acknowledged in the editorial that measles — one of the most contagious viruses in the world — is especially risky to unvaccinated people. He stopped short of urging the public to get the MMR vaccine.
“The decision to vaccinate is a personal one,” Kennedy wrote.
Some pediatricians and public health experts have balked at the editorial, saying it was nothing more than a thinly veiled attempt to comfort his anti-vaccine supporters amid backlash after he appeared to downplay the outbreak during a Cabinet meeting at the White House last week.
“While he kind of gives some lip service to the vaccines,” said Dr. Amesh Adalja, a senior scholar at the Johns Hopkins Center for Health Security, “the fact that he used phrases like ‘personal’ choice is a wink and a nod to the anti-vaccine movement. They know he’s their man.”
Dr. Molly O’Shea, a Michigan pediatrician and spokesperson for the American Academy of Pediatrics, said the fact that Kennedy didn’t fully back vaccines is “concerning.”
“He certainly did not disparage vaccination in the way he worded it, but he did not come out with a strong statement of support for vaccination,” O’Shea said. “Vaccination is by far the most effective strategy at reducing morbidity and mortality from measles. That was not his go-to message.”
It’s a stark contrast in messaging from the previous Trump administration.
In 2019, when two measles outbreaks in New York threatened to reverse the United States’ status of having eliminated measles, then-HHS Secretary Alex Azar didn’t mince words.
“Measles vaccines are among the most extensively studied medical products we have, their safety has been firmly established over many years,” Azar said in an April 2019 HHS statement.
He went on to say that “measles is not a harmless childhood illness, but a highly contagious, potentially life-threatening disease.”
At the time, Kennedy told members of the Children’s Health Defense, an anti-vaccine nonprofit that he founded, that the MMR vaccine is worse “than the illness it’s pretending to prevent.” He didn’t provide scientific evidence to back up the statement, flummoxing vaccine experts.
“Vaccination is far and away the most effective means to protect individuals and their communities against measles,” said Dr. Ofer Levy, director of the Precision Vaccines Program at Boston Children’s Hospital. “If you want to get on top of this thing, that’s the answer.”
A spokesperson for HHS didn’t respond to questions about Kennedy’s editorial.
The vitamin A theory
There’s no antiviral or specific treatment used for measles in the U.S.
In the editorial and in an interview with Fox News Tuesday, Kennedy doubled down on a treatment often reserved for other countries: vitamin A.
“We’re delivering vitamin A,” Kennedy said in reference to how the federal government is helping in the outbreak. “Also cod liver oil, which has high, high concentrations of vitamin A,” he said.
It’s true that vitamin A is sometimes given to help treat measles in low-income countries where malnutrition is a factor, according to the World Health Organization. Most people in the U.S., however, have normal levels of the vitamin and don’t need any kind of vitamin A supplementation. Too much, experts say, is toxic.
Vitamin A is fat-soluble, meaning it accumulates in the body rather than exiting through urination. That is, the more vitamin A you take, the more it accumulates in organs like the liver.
“You can easily overdose on vitamin A,” Dr. Ronald Cook, chief health officer at both the Texas Tech University Health Sciences Center in Lubbock and the city’s Health Authority, said in an interview Friday. “It’s not to be used over the counter for anybody who says, ‘my kid has the sniffles. Maybe it’s measles.’ Don’t do that.”
Anti-vaccine influencers and organizations have rallied around vitamin A as protection against and treatment for measles for years. During outbreaks, anti-vaccine groups have organized drives to fundraise and send vitamin A to affected communities.
Adalja of Johns Hopkins said Kennedy’s references to vitamin A only serve to discourage the MMR vaccine among his followers.
“When RFK Jr. is talking about vitamin A, people are going to say, oh, that’s his code word that we should be doing that, not the MMR vaccine,” Adalja said.
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