Vitamin A, While Helpful for Measles, Is Not a Replacement for Vaccination

American Academy of Pediatrics (AAP) urge vitamin A for each patients with measles -- not conscionable terrible cases -- but experts pass that this shouldn't beryllium seen arsenic a replacement for vaccination.

In a recent sentiment piece for Fox News, HHS Secretary Robert F. Kennedy Jr. wrote that studies enactment the medication of vitamin A "under the supervision of a doc for those with mild, moderate, and terrible infection" and that it tin reduce mortality from the disease.

He besides indicated that the CDC had precocious broadened its recommendation to usage vitamin A successful each measles cases, not conscionable terrible disease.

While Kennedy appeared to enactment measles vaccination successful that sentiment portion -- helium wrote that vaccines "contribute to assemblage immunity, protecting those who are incapable to beryllium vaccinated owed to aesculapian reasons" -- helium besides noted that the prime to vaccinate is simply a idiosyncratic one.

Taken together, experts person raised concerns astir a imaginable misinterpretation of Kennedy's message: that due to the fact that vitamin A is available, they don't request to beryllium vaccinated.

"Vitamin A is perfectly not a substitute nor an equivalent for MMR vaccination, which is the champion mode to forestall a kid from getting measles," Ericka Hayes, MD, of Children's Hospital of Philadelphia, told MedPage Today.

Indeed, the measles, mumps, and rubella (MMR) vaccine is "one of the astir effectual and durable vaccines that we have," she said, with the afloat two-dose bid being 97% effectual against measles.

"I deliberation immoderate radical are thinking, 'Oh, well, then, if I, for example, instrumentality vitamin A, I won't get measles, oregon I'm little apt to get measles,'" Hayes said. "And that is perfectly not the case."

Much of the lit astir vitamin A and measles comes from lower- and middle-income countries, wherever deficiency whitethorn airs much of a problem. However, fixed that vitamin A deficiency tin enactment kids astatine hazard of worse outcomes with measles -- and astir kids aren't assessed for vitamin A levels -- U.S. adept statement has settled connected administering the vitamin successful each cases.

Tina Tan, MD, of Northwestern University, who is president of the Infectious Diseases Society of America, said vitamin A "really plays an important relation successful maintaining a steadfast immune strategy and supports the relation of immune cells truthful the assemblage tin combat disconnected infections similar measles."

However, taking vitamin A won't forestall a kid from getting measles successful the archetypal place, Hayes said, and it tin person "significant toxicities," particularly erstwhile taken successful precocious doses. "And conscionable due to the fact that you're taking vitamin A oregon person a bully vitamin A level doesn't warrant that you volition not person a ... terrible lawsuit of measles," she added.

The AAP Red Book -- an encyclopedia of pediatric infectious diseases -- noted that U.S. experts concur with WHO recommendations connected giving vitamin A to each children with measles, and recommends giving it erstwhile a time for 2 days astatine the pursuing doses:

• 50,000 IU for infants younger than 6 months

"Again, if a kid has measles, that vitamin A should beryllium prescribed nether the supervision of the doc to marque definite that it is dosed appropriately," Hayes said.

Still, some Hayes and Tan emphasized that vaccination is the lone mode to halt much measles outbreaks similar the existent 1 successful westbound Texas, wherever 159 cases person been identified since precocious January, with 22 hospitalizations and 1 decease -- the first measles decease successful the U.S. since 2015.

Tan said that the "number of unvaccinated individuals is growing, and that fundamentally increases the hazard for dispersed of measles, due to the fact that measles is 1 of the astir contagious viruses."

"If we cannot get our vaccination rates up to wherever they were, we're going to proceed to spot these outbreaks," she added, and that could mean much deaths, arsenic it's estimated that 1 to 3 children successful 1,000 with measles volition die.

Measles tin besides origin complications aft the archetypal unwellness has passed, including subacute sclerosing panencephalitis -- a rare, though fatal, neurologic illness -- and immunodeficiency, Hayes said.

"I ever find measles highly concerning due to the fact that it is truthful contagious," Hayes said. There are "so galore individuals successful this state who are not immune," specified arsenic infants nether 1 twelvemonth of age, who cannot beryllium vaccinated yet, and individuals who are immunocompromised, she added. And determination is simply a "risk for precise terrible illness arsenic good arsenic complications -- some acute complications arsenic good arsenic semipermanent complications -- with this virus."