As of Friday, the Texas Department of State Health Services had reported 481 confirmed cases of measles, which would put the total number of cases in the U.S. well over 600 since the start of the year. During all of 2024, fewer than 300 measles cases were reported across the entire United States.
Another thing is showing up in the routine lab work for unvaccinated children with measles: liver damage.
More than 50 children have been hospitalized in Texas, and the vast majority of cases and hospitalizations are occurring in unvaccinated kids. One unvaccinated school-age child has died. In addition to measles itself, another thing is showing up in the routine lab work for unvaccinated children with measles: liver damage. According to the physicians treating such children at Covenant Children’s Hospital in Lubbock, vitamin A toxicity from high doses of cod liver oil is the most likely culprit.
Cod liver oil, which Health and Human Services Secretary Robert F. Kennedy Jr. has touted in several Fox News interviews as a cure and prophylaxis for measles, contains a rich amount of vitamin A. Symptoms of vitamin A toxicity include dry skin, fatigue, blurred vision, bone pain and the above-mentioned liver damage. In some cases, too much vitamin A can cause a person to fall into a coma or even die.
Since the beginning of the measles outbreak in Texas, Kennedy has downplayed the role of vaccines in preventing measles. In a March 2 op-ed that he wrote for Fox News’ website, he claims to care about the dissemination of “accurate information about vaccine safety and efficacy” and says vaccines should be available “for all those who want them.”
But in the same piece, Kennedy writes that it is also “our responsibility to provide up-to-date guidance on available therapeutic medications.” That’s when he argues that the “CDC has recently updated their recommendation supporting administration of vitamin A under the supervision of a physician for those with mild, moderate, and severe infection. Studies have found that vitamin A can dramatically reduce measles mortality.”
Despite Kennedy’s claims that cod liver oil, steroids and antibiotics can be used to prevent or treat measles, the only evidence-based method that has been shown to prevent against a measles infection is vaccination. According to the Centers for Disease Control and Prevention, two shots of the MMR vaccine provides 97% protection against the disease.
Symptoms of vitamin A toxicity include dry skin, fatigue, blurred vision, bone pain and liver damage. In some cases, too much vitamin A can cause a person to fall into a coma or even die.
Children showing up at hospitals with vitamin A toxicity underscores the importance of effective communication of lifesaving information.
With the exception of measles cases that are the result of international travelers bringing it into the U.S., the disease has spread across 19 states because of misinformation. Instead of deliberately and intentionally advocating for parents to inoculate their children against measles, as every responsible public health official should, Kennedy has instead expressed support for alternative therapies that are proven not to prevent measles.
Words matter, particularly the words from leaders who have the power and influence to shape public behavior. Words have consequences, and we can see the results of inaccurate public health messaging in Texas. Parents are deciding on alternative therapies to treat measles rather than giving their children the vaccines that science shows prevent infection.
These parents are causing their own children to suffer. No otherwise healthy child should be in the hospital. They should be enjoying their childhood playing outside with family and friends. Instead, these children with vitamin A toxicity are being hospitalized, put on medications and being given fluids intravenously. The vast majority of the measles cases across the United States, and certainly all the hospitalized cases, could be entirely prevented with vaccines. The measles outbreak will not improve until vaccination rates improve and a concerted effort is made to combat the rise of vaccine hesitancy that Kennedy and other anti-vaccine advocates have push onto many Americans. To that end, our influential public health leaders must provide clarity and transparency when discussing and educating the public about how to prevent measles. It is not enough to claim that vaccines are an important part of measles prevention but then promote cod liver oil, antibiotics and steroids for therapy when an active measles outbreak is affecting hundreds of Americans. Lives are at stake. One child has already died, and that’s one too many. If innocent children continue to suffer and be hospitalized for a completely preventable disease, shouldn’t leaders who are spreading misinformation be held accountable? Where is the justice for the dozens of people, most of them children, who are suffering in Texas hospitals because their parents used remedies recommended by irresponsible government officials? In a time where misinformation can spread swiftly through social and mass media, we need real public health leaders who can communicate effectively and clearly. The lives of our children depend upon it.
Dr. Omer Awan
Dr. Omer Awan M.D., MPH, CIIP, is a practicing radiologist physician in Baltimore, Maryland, who writes about the most pressing issues in healthcare and public health. 
