A growing number of children hospitalized during Texas's measles outbreak are showing signs of vitamin A toxicity, as Health and Human Services Secretary Robert F. Kennedy Jr. continues to promote cod liver oil and high-dose vitamin A as alternative treatments for the disease. The Centers for Disease Control and Prevention reports that 483 confirmed measles cases have been documented across 20 states this year, including at least 400 in Texas.
The outbreak has already resulted in the first measles death in the United States in a decade, with a second under investigation in New Mexico. At Covenant Children's Hospital in Lubbock, several unvaccinated children being treated for measles have also tested positive for elevated liver enzymes, a common sign of vitamin A overdose.
Kennedy has claimed in recent interviews that "vitamin A and cod liver oil" are effective treatments for measles and has suggested that poor nutrition may be responsible for the severity of cases. In a recent Cabinet meeting, Kennedy downplayed the outbreak, calling it "not uncommon," despite measles being declared eliminated from the U.S. in 2000.
"Vitamin A may be administered therapeutically to individuals who are already infected with measles, particularly in children with vitamin A deficiency, where it has been shown to help reduce the severity and complications of the disease," the Council for Responsible Nutrition stated. "However, this use is a targeted, short-term medical intervention-not a preventive measure-and should only be done under the direction of a qualified healthcare professional."
The CDC has included vitamin A in its measles treatment guidelines for specific cases, but emphasizes that vaccination remains the only proven method of prevention. Two doses of the MMR vaccine are 93% effective against measles, and 97% of current patients are either unvaccinated or have unknown vaccination status, according to the agency.
In Texas, however, the use of vitamin A supplements appears to have become a substitute for the vaccine among some families. "Patients that are showing signs of vitamin A toxicity should stop using the vitamin immediately and seek medical care," according to health experts familiar with the hospital cases. Acute toxicity can cause headaches, vomiting, and abdominal pain, while chronic overdose may result in liver damage, hair loss, bone weakening, and even birth defects in pregnant women.
Vitamin A deficiency is rare in the United States, where the nutrient is abundant in foods such as eggs, dairy, leafy greens, and fortified cereals. In contrast, vitamin A therapy has a clearer role in low-income countries where such deficiencies are widespread and measles complications more common.
The CDC has faced internal tension over its public messaging. According to ProPublica, CDC leadership blocked a staff report warning of the rising risk of outbreaks in areas with low vaccination rates. "The risk of catching measles is high in areas near outbreaks where vaccination rates are lagging," the draft report stated.
Kennedy's advocacy of vitamin A and downplaying of vaccine efficacy have drawn sharp criticism from public health officials. "There are very few vaccines that are as highly effective as the MMR vaccine in preventing disease," said one expert. "Vitamin A is not a substitute."
As of March 27, 42% of measles cases were in children aged 5-19, and 33% were under five years old. Public health officials warn that mixed messages and unverified claims could exacerbate the crisis.
