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Vitamin A and measles — what are the facts

With the current measles outbreak across parts of the USA, individuals like HHS Secretary Robert F Kennedy Jr are touting vitamin A to prevent or treat measles. RFK Jr uses a tiny morsel of scientific fact to support a false and dangerous claim.

Kennedy has claimed that vitamin A and cod liver oil are effective treatments for measles. He also said that poor diet contributes to severe cases of measles, which is linked to his ideas about vitamin A.

This article will examine the basis for his beliefs and why vitamin A is not a proper prevention or treatment for measles.

woman in white jacket holding mobile phone measles vitamin a

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Vitamin A and measles facts

Vitamin A is essential for our overall health. It is in a class of nutritional compounds called antioxidants. It is needed by the body to help with vision, reproduction, cell growth, and the immune system. It protects your cells against free radicals and supports cell growth and function. It has many roles in the body, from supporting growth and reproduction to healthy vision, skin, and immune function.

Foods rich in vitamin A or related molecules include orange, yellow, and red-colored fruits and vegetables, and green leafy vegetables. It is also found in dairy, egg, fish, and meat. Of course, it can be taken as a supplement.

People most at risk for vitamin A deficiency are those with a limited variety of food in their diet, with cystic fibrosis, or with malabsorption problems (problems absorbing food). In the USA, where malnutrition is not common, vitamin A deficiency is extremely rare.

Vitamin A can also be used therapeutically, and physicians may prescribe vitamin A to treat a deficiency. Vitamin A deficiency has long been associated with more severe cases of infectious diseases, including measles. Vitamin A boosts immune cells and strengthens the respiratory tract lining, which is the body’s first defense against infections.

Vitamin A supplementation is necessary for people with chronically low levels of the vitamin, which could lead to a much higher susceptibility to measles complications, including death. People who consume normal levels of vitamin A are not at increased risk of measles complications, although they can still happen. Vitamin A has been used as a supportive therapy for children with severe measles, particularly in low- and middle-income countries where malnutrition is common.

Because of this, the CDC has recently stated that vitamin A can also be prescribed as part of treatment for children with severe measles, especially ones who have been hospitalized, but under a physician’s supervision.

But let’s be clear what the CDC is saying — vitamin A supplementation is indicated for children hospitalized for measles, but it does not claim that it prevents measles. The only prevention for measles is the MMR vaccine (against measles, mumps, and rubella).

Furthermore, there is no evidence that excess supplementation of vitamin A, if you have normal levels, will provide any benefit whatsoever. One of the fallacies of supplements is that if a little is good, a lot is better. Essentially, it’s an on/off switch — if you have normal vitamin A levels from your diet, that’s good enough, taking more isn’t going to make you super immune to measles or treat it faster.

If you live in the USA or another developed country, your diet gives you all the vitamin A you need. If for some reason you have a low level of the vitamin, as determined by blood tests, then it may be important to supplement with vitamin A.

RFK Jr also mentioned cod liver oil for children who contracted measles because it’s high in vitamin A. Once again, Kennedy fails to use science to support his claims, because no published evidence shows that cod liver oil does anything for measles.

But let’s make this clear — it is not a treatment for measles, unless you are malnourished or have some other conditions that reduce vitamin A blood levels, and it does not prevent measles or its serious complications.

woman hand and pills in bowl

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Vitamin A can be dangerous

One other problem with Kennedy’s claims is that large amounts of vitamin A can be toxic. Vitamin A should be taken under medical supervision, under specific circumstances, where patients can be closely monitored to prevent toxicity from high doses.

Vitamin A toxicity can cause birth defects and increase the risk of fractures in elderly people. Vitamin A and beta-carotene (which the body turns into vitamin A) from supplements may also increase your risk of cancer, especially if you smoke.

For those of you who believe that if a small amount works, then a bunch more works a lot better, vitamin A can be dangerous with a lot.

If a child gets measles and needs to be hospitalized, a physician will determine how much vitamin A will be given to that child. A parent should not be deciding how much of the vitamin should be given if that child has measles.

Where did Kennedy get this idea?

RFK Jr cited a 2010 study, a systematic review and meta-analysis, which included studies that examined the effectiveness of vitamin A in preventing measles deaths.

The researchers reviewed three studies that investigated vitamin A treatment by specific dose. They found that two doses of vitamin A (200,000IU for children over one year of age or 100,000IU for infants below one year) reduced mortality by 62% compared to children who did not have vitamin A.

The study did not show that vitamin A reduced the risk of getting measles from another infected person. No study has shown that.

I am concerned about the reviewed studies because they did not provide a comparison of reduction in mortality risk with information about prior levels of vitamin A. That is, did the risk reduction only occur in individuals with low vitamin A levels or was it in all individuals? I could not tell from the article, though based on the populations involved, I would conclude that they had low levels of vitamin A consumption.

Summary

So Kennedy has pushed vitamin A to prevent measles, but there is just no evidence that supports that claim. Although vitamin A may lower the risk of death from measles, it does not eliminate complications from the disease.

Vitamin A is used to treat measles in hospitalized children under physician supervision. I see no evidence that it prevents hospitalization (although that outcome may not have been studied), and it certainly does not prevent measles or its complications.

I am concerned that people will shove a handful of vitamin A capsules into their children’s mouths in the hope that it will prevent measles or make it less severe. That could be dangerous, and it isn’t going to do what they want.

The measles vaccine prevents measles, so you don’t have to worry about vitamin A.

Citations

Abadie RB, Staples AA, Lauck LV, Dautel AD, Spillers NJ, Klapper RJ, Hirsch JD, Varrassi G, Ahmadzadeh S, Shekoohi S, Kaye AD. Vitamin A-Mediated Birth Defects: A Narrative Review. Cureus. 2023 Dec 14;15(12):e50513. doi: 10.7759/cureus.50513. PMID: 38226115; PMCID: PMC10788247.

Institute of Medicine (US) Committee on Military Nutrition Research. Military Strategies for Sustainment of Nutrition and Immune Function in the Field. Washington (DC): National Academies Press (US); 1999. 12, Vitamin A and Immune Function.

Mubbashir Z, Tharwani ZH, Kambar T, Munawar S, Raphael O, Siddiqui I, Nadeem SA, Amir A, Ahmed A, Bin Zafar MD, Anjum MU, Hasanain M, Malikzai A. Subacute Sclerosing Panencephalitis: Impact on Public Health, Current Insights, and Future Perspectives. Brain Behav. 2025 Feb;15(2):e70292. doi: 10.1002/brb3.70292. PMID: 39924947; PMCID: PMC11808179.

Sudfeld CR, Navar AM, Halsey NA. Effectiveness of measles vaccination and vitamin A treatment. Int J Epidemiol. 2010 Apr;39 Suppl 1(Suppl 1):i48-55. doi: 10.1093/ije/dyq021. PMID: 20348126; PMCID: PMC2845860.

Wu AM, Huang CQ, Lin ZK, Tian NF, Ni WF, Wang XY, Xu HZ, Chi YL. The relationship between vitamin A and risk of fracture: meta-analysis of prospective studies. J Bone Miner Res. 2014 Sep;29(9):2032-9. doi: 10.1002/jbmr.2237. PMID: 24700407.

Michael Simpson

Lifetime lover of science, especially biomedical research. Spent years in academics, business development, research, and traveling the world shilling for Big Pharma. I love sports, mostly college basketball and football, hockey, and baseball. I enjoy great food and intelligent conversation. And a delicious morning coffee!