It didn’t take lengthy for considerations about RFKs unscientific ideological strategy to healthcare to manifest. We’re in the midst of a measles outbreak – the precise sort of scenario for which we want a robust federal response. The individual accountable for that response, RFK Jr., is a infamous anti-vaccine crank who is just not a scientist or healthcare skilled, regardless that he acts as if he’s.
His response to the outbreak has not been as dangerous as feared, in that he does assist using vaccines and does say that vaccines work to stop illness and supply group immunity. However he pairs that with the anti-vaccine canine whistle of claiming that vaccines are a private alternative. He then instantly pivots to touting vitamin A and cod liver oil as therapies for measles, saying that, “Research have discovered that vitamin A can dramatically scale back measles mortality.” He hyperlinks to this 2010 examine.
It is a nice instance of how straightforward it’s to mislead by presenting scientific proof, by means of cherry selecting and misrepresentation. Kennedy additionally cites that the CDC now recommends vitamin A for the remedy of measles. However that is what the CDC has to say:
“Supportive care, together with vitamin A administration underneath the route of a doctor, could also be acceptable.”
That could be a fairly luke heat advice. Docs additionally perceive what “supportive care” means – it’s not a preventative or a therapeutic. It “might” assist the affected person climate the stress of the sickness. Let’s check out the info to see what it really exhibits.
Right here is the newest systematic evaluate I might discover, from 2017, which concludes:
“At longest follow-up, there was a 12% noticed discount within the danger of all-cause mortality for vitamin A in contrast with management utilizing a fixed-effect mannequin (danger ratio (RR) 0.88, 95% confidence interval (CI) 0.83 to 0.93; high-quality proof).”
That could be a 12% discount in mortality, not the 65% cited by RFK’s examine. But additionally we now have to dig a bit deeper into the info. The evaluate additionally discovered no preventive profit from vitamin A – one thing that may be price declaring to the general public, who might not distinguish between a supportive remedy and a preventive technique.
There may be concern that some individuals are utilizing vitamin A routine supplementation, generally in excessive doses, to stop measles, prompting accountable healthcare specialists to particularly level out that this doesn’t work and vitamin A is just not an alternative choice to vaccination. Additionally, vitamin A is probably going the most poisonous vitamin in excessive doses, which can also be necessary to warn the general public about.
Nonetheless, you may be pondering, a 12% discount in mortality is important and the general public must be made conscious of this. However the information exhibiting a discount in mortality from measles utilizing vitamin A is proscribed to nations the place vitamin A deficiency is rampant. Measles may cause an additional depletion of vitamin A, and each measles and vitamin A deficiency weaken the immune system. So sure, in components of the world the place vitamin A deficiency is frequent, focusing on these with measles for vitamin A supplementation is useful. The info exhibits is works for kids lower than two years outdated, and with two excessive dose administrations of vitamin A.
Does this information apply to a measles outbreak within the US? No, under no circumstances. In truth, the one examine particularly vitamin A for the remedy of measles in a excessive earnings nation discovered no profit.
It’s subsequently extra correct to say that younger kids at excessive danger for vitamin A deficiency must be particularly focused for supplementation in the event that they contract measles or throughout a measles outbreak. However vitamin A is just not a selected remedy for measles, it has no profit in kids who are usually not at excessive danger of vitamin A deficiency, and it has no function in prevention.
Simply saying that “research have discovered” vitamin A to “dramatically scale back measles mortality” within the context of an outbreak in Texas is greater than deceptive. It’s harmful. It would doubtless have an effect on public conduct which is counter productive (basic RFK jr).
What the general public must be advised, if they’re advised something, is what all the info, put into a correct medical context, really is telling us – whereas vitamin A could also be useful for supportive care of some sufferers, vitamin A is unlikely to be of any profit in a measles outbreak within the US. It’s not a remedy for measles itself, and it’s not efficient for prevention. Solely vaccines (together with isolation and avoidance of contact) can successfully forestall the contraction of measles, which is a extremely contagious sickness. Don’t take excessive doses of vitamin A, and don’t use vitamin A to self-treat measles or as an alternative choice to the vaccine.
