By Julie Steenhuysen
CHICAGO (Reuters) -U.S. pediatricians and infectious disease experts say the fight against rising measles cases nationwide is being hampered by a lack of forceful advocacy for vaccination from government health officials and statements on unproven treatments that are confusing parents.
Since January, 505 people have been infected in Texas and more than 90 total in neighboring New Mexico, Oklahoma and Kansas. Two children have died in Texas, including an 8-year-old girl last week, and an adult death in New Mexico is under investigation. The United States has more than 600 known cases and outbreaks in six states, according to HHS.
Dr. Sue Kressly, president of the American Academy of Pediatrics, said leaders need to speak with a consistent science- and fact-based message about measles vaccination, calling that the only way to handle an outbreak like this. “That is the number one message we’re trying to put in front of everyone.”
Robert F. Kennedy Jr., who has a long history of advocating against vaccines, has backed vaccination as the best way to prevent measles from spreading since becoming the head of the U.S. Department of Health and Human Services.
But unlike previous health secretaries faced with containing outbreaks, his comments are not unequivocal. He has also made misleading claims about nutrition, vitamin A and other treatments, while exaggerating vaccine risks, even as U.S. vaccination rates are falling.
“Our work is becoming harder by the minute,” said Dr. Rana Alissa, president of the American Academy of Pediatrics’ Florida chapter, a state where kindergarten vaccination rates last school year were 81%, far below the 95% needed to establish community protection.
An HHS spokesman in a statement disputed that there was a lack of strong federal messaging, saying Kennedy has repeatedly reinforced the important role of vaccines. The spokesman said HHS and the Centers for Disease Control and Prevention have been monitoring the situation and are collaborating with state and local health authorities, including by providing resources.
“Secretary Kennedy remains committed to ensuring Americans have accurate information on all available treatment options,” the statement said.
In an interview on CBS News on Wednesday, Kennedy repeated that it was his and the government’s position that people should get the measles vaccine.
On Sunday, however, he followed a post on X championing the vaccine with another praising alternative treatments, drawing fresh criticism from disease experts.
The CDC, the nation’s lead agency on infectious disease outbreaks which reports to Kennedy, has made just two official public statements and provided a weekly tally of cases on its website. HHS said the CDC has issued statements and updates as needed.
Dr. Paul Offit, director of the Vaccine Education Center at the Children’s Hospital of Philadelphia, said the CDC needs to conduct frequent press conferences and issue multiple press releases urging Americans to vaccinate their children.
In 2019, when a New York measles outbreak recorded 1,274 cases, CDC officials did just that and New York City made the vaccine mandatory, issuing summonses to families who failed to comply.
That year, Health Secretary Alex Azar forcefully endorsed the measles vaccine, calling it “among the most-studied medical products we have”, and launched a national immunization campaign.
Doctors are looking to fill in the communication void. AAP has produced new website content, several press releases, 20 social media posts and launched a misinformation-fighting initiative, aimed at clarifying the safety of vaccines and the role of Vitamin A, which Kennedy has touted.
There is no treatment for the highly contagious vaccine-preventable disease beyond those to address symptoms and complications, AAP’s Kressly said.
Vitamin A is only recommended when administered by a doctor in specific quantities as too much can cause liver damage. Some pediatricians in Texas have reported cases of liver toxicity among children, Kressly said.
In his Sunday X post, Kennedy promoted the inhaled steroid budesonide, which is used to treat asthma, and the antibiotic clarithromycin.
Antibiotics cannot treat a viral infection and using an inhaled steroid to treat measles-related inflammation is risky because it suppresses the immune system, which could make the infection “significantly worse,” said Dr. Tina Tan, a professor of pediatric infectious diseases at Northwestern University and president of the Infectious Diseases Society of America.
‘MASSIVE EPIDEMIC’
The Texas outbreak likely involves thousands of cases as official case counts only tally laboratory-confirmed cases, Offit said. “This is a massive measles epidemic.”
Measles typically causes one-to-three deaths per 1,000 cases. Three deaths linked with the Texas outbreak suggest there could be as many as 1,000 to 3,000 cases, epidemiologist Dr. Katelyn Jetelina wrote in her Substack blog on Monday.
Rising vaccine skepticism and misinformation have resulted in only 11 U.S. states with vaccination rates of 95% or above – the level needed to protect residents unable to receive the vaccine. The measles vaccine is 97% effective after two doses and 93% after one.
Dr. Michael Donnelly, who crafts messaging for pediatricians across Medstar Health’s 10 hospitals in the Washington D.C. and Baltimore areas, said Kennedy’s comments set this year apart from the concerns raised by parents in prior years.
“On one side, you have people panicking when they don’t need to. And then on the other side, you have people who are pretty blase.”
Dr. Alisa Kachikis, who cares for women with high-risk pregnancies at UW Medicine in Seattle, noted that measles can cause miscarriage and birth defects. She recommends pregnant women who are unvaccinated get the shot right after delivery to protect their baby.
The vaccine can’t be given to children younger than six months and is usually not given until a child reaches 12 months.
Dr. Theresa Horton, a pediatrician in Owasso, Oklahoma, said she used to tell parents if they didn’t vaccinate their children, they were relying on others who were vaccinated to protect them.
With vaccination rates among Oklahoma kindergartners hovering around 88%, she now tells them: “We no longer have herd immunity.”
(Reporting by Julie Steenhuysen; Editing by Caroline Humer and Bill Berkrot)
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