American Academy of Pediatrics The AAP recommends vitamin A for all patients with measles, not just severe cases, but experts warn that it should not be considered a replacement for vaccination.
IN recent opinion For Fox NewsSecretary of Health Robert F. Kennedy Jr. wrote that research supports the administration of vitamin A “under medical supervision to people with mild, moderate, and severe infection” and that it may reduce mortality from illness.
He also noted that the CDC recently expanded his recommendation use vitamin A in all cases of measles, and not just in severe cases of the disease.
While Kennedy appeared to support measles vaccination in his op-ed—he wrote that vaccines “promote herd immunity by protecting those who cannot be vaccinated for medical reasons”—he also noted that the choice to get vaccinated is a personal one.
Collectively, experts expressed concern that Kennedy's message might be misinterpreted: Because vitamin A is available, they don't need to get vaccinated.
“Vitamin A is absolutely neither a replacement nor an equivalent to the MMR vaccine, which is the best way to prevent a child from getting measles,” said Erica Hayes, MD, of the Children's Hospital of Philadelphia. MedPage today.
Indeed, the measles, mumps and rubella (MMR) vaccine is “one of the most effective and durable vaccines we have,” she said, with a full two-dose series already developed. 97% effective against measles.
“I think some people think, 'Well, then if I take vitamin A, for example, I won't get measles or I'll be less likely to get measles,'” Hayes said. “And this is absolutely not true.”
Much of the literature on vitamin A and measles comes from low- and middle-income countries, where deficiency can be a major problem. However, given that vitamin A deficiency can put children at risk for worse outcomes from measles – and most children do not have their vitamin A levels checked – experts in the US have agreed on prescribing the vitamin in all cases.
Tina Tan, MD, of Northwestern University, president of the Infectious Diseases Society of America, said vitamin A “really plays an important role in maintaining a healthy immune system and supporting immune cell function so the body can fight off infections like measles.”
However, taking vitamin A will not prevent a child from getting measles, and it can have “significant toxicity,” especially when taken in high doses, Hayes said. “And the fact that you take vitamin A or have good vitamin A levels does not guarantee that you won't have … a severe case of measles,” she added.
AARP Red Book — Encyclopedia of Pediatric Infectious Diseases — noted that American experts agree with WHO recommendations for the administration of vitamin A to all children with measles, and recommend giving it once a day for 2 days in the following doses:
- 50,000 IU for children under 6 months.
“Again, if a child has measles, vitamin A should be prescribed under the supervision of a physician to ensure that the dosage is appropriate,” Hayes said.
However, both Hayes and Tan stressed that vaccination is the only way to stop new measles outbreaks like the current one in West Texas, where 159 cases have been identified since late January: 22 hospitalizations and one death. first death from measles in the US since 2015.
Tan said that “the number of unvaccinated people is increasing, and this essentially increases the risk of measles spreading, since measles is one of the most contagious viruses.”
“If we can't get vaccination rates up to par, we'll continue to see these outbreaks,” she added, and that could mean more deaths as between one and three children in 1,000 are estimated to die from measles.
Measles can also cause complications after the initial illness has passed, including subacute sclerosing panencephalitis – a rare though fatal neurological disease – and immunodeficiency, Hayes said.
“I'm always really concerned about measles because it's so contagious,” Hayes said. “There are so many people in this country who are not immune,” such as infants under 1 year of age who cannot yet be vaccinated and people who are immunocompromised, she added. And there is “a risk of very severe illness, as well as complications – both acute and long-term – from this virus.”
