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Health experts wary as US health secretary fails to endorse effective vaccines and instead calls them a ‘personal choice’

Robert F Kennedy Jr, the US health secretary, has caused alarm among pediatricians, vaccine experts and lawmakers with an opinion piece that focuses on vitamin A and nutrition as treatments for measles.

In response to a measles outbreak in Texas, which resulted in the first American measles death in nearly a decade, Kennedy wrote for Fox News about the benefits of “good nutrition” and vitamin A – but did not explicitly recommend highly effective vaccines.

“In fact, relying on vitamin A instead of the vaccine is not only dangerous and ineffective, but it puts children at serious risk,” Dr Sue Kressly, the president of the American Academy of Pediatrics, told the Washington Post.

Measles is one of the most infectious diseases in the world. Infections kill one to three people for every 1,000 infected and can cause severe brain swelling, called encephalitis, in one in 1,000 cases. The disease also causes general misery, including a characteristic top-down rash, fever, runny nose, and red and watery eyes. The measles vaccine is 97% effective at preventing the disease.

At least 146 people have been sickened in Texas, primarily in unvaccinated communities in the South Plains region. More than 20 people have been hospitalized, and an unvaccinated school-aged child died – the first American measles death since April 2015.

Kennedy’s initially muted response to the outbreak has drawn intense criticism. Kennedy erroneously said in a cabinet meeting that the outbreak killed two people in Texas, and then, “it’s not unusual” to have outbreaks. In fact, measles sickened 285 people in the entirety of 2024. The Texas outbreak alone accounts for nearly half of last year’s total relatively early in the year.

Over the weekend, Kennedy then penned an opinion piece in Fox News in which he argued vaccination was a “personal choice”, said vitamin A could “dramatically reduce measles mortality” and stopped short of explicitly recommending measles vaccination.

“Good nutrition remains a best defense against most chronic and infectious illnesses,” Kennedy wrote. “Vitamins A, C, and D, and foods rich in vitamins B12, C, and E should be part of a balanced diet.”

Although studies have shown that vitamin A could be an effective supportive therapy for children already infected with measles, most research has been conducted in low- and middle-income countries, particularly in Africa, where measles death rates and malnutrition are more common.

“It could lead to the impression of a false equivalency,” Dr Peter Hotez, the dean of the National School of Tropical Medicine at Baylor College of Medicine and the co-director of Texas Children’s Hospital Center for Vaccine Development, told the Post. “To make the best decision for your children, you can either vaccinate or give vitamin A … That would be highly misleading.”