Measles is not a nutrient deficiency–you can’t kale and quinoa your way out of viral infections

The ongoing measles outbreak is not in malnourished people, it’s in unvaccinated people.

Mar 24, 2025

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Is America Healthy yet? Anyone else ready to be done with this living nightmare?

A quick rundown: we have 378 confirmed measles cases in the US this year, as of Friday, March 21, 2025, 64 requiring hospitalization (17%, if you’re wondering), the majority of which are children.

In Texas alone, 309 cases are confirmed, 40 requiring hospitalization. There have already been 2 confirmed deaths, both in unvaccinated people. The US has not seen a death due to measles in a decade–because we have had extremely safe and effective vaccines for measles for over sixty years.

Measles cases have also been reported in 17 other states so far: Alaska, California, Florida, Georgia, Kansas, Kentucky, Maryland, Michigan, New Jersey, New Mexico, New York City, New York State, Ohio, Pennsylvania, Rhode Island, Texas, Vermont, and Washington.

There were a total of 295 cases in the ENTIRETY of 2024 in the US. It is March right now – not even a quarter of the way into 2025. Our track compared to where we were last year, paints a very dire picture if people do not get vaccinated, and quickly.

RFK Jr – a man with ZERO scientific or medical expertise who openly denies widely held scientific truths – is in charge of health policy in the US. This reality isn’t just inappropriate, it’s deadly.

Senators, do you have buyer’s remorse? Bill Cassidy, are you out there?

In the midst of the worst measles outbreak in the US in decades–which is spreading because people are not vaccinated for measles–RFK is STILL spreading lies about vaccines and health.

In the last 2 weeks, he has repeatedly amplified blatantly false statements undermining vaccines and overstating the impact of nutrition in measles prevention. These include:

An Op-Ed published on FOX, where he danced around the importance of vaccines while suggesting vitamin A supplementation, hygiene, and unproven remedies are on par (or better) than vaccination.
An interview on FOX with Marc Siegel, where he stated it is "almost impossible" for healthy individuals to die from infectious disease and that the child who died may have been malnourished (she wasn’t).
And on Sean Hannity where he stated again that “the people who tended to die were people with comorbidities and they were malnourished,” and then said it wasn’t a problem because the Supplemental Nutrition Program for Women, Infants, and Children came around in 1964 (it didn’t it began in 1972).

These statements are dangerous and reckless disinformation coming directly from the official charged with safeguarding American public health.

This measles surge is driven by declining vaccination rates and increasing vaccine hesitancy. At a time like this, we need clear and science-driven accurate health leadership. Instead, we have RFK Jr., a wellness profiteer who has fabricated some of the most harmful medical conspiracies in recent decades, with the megaphone of the Federal government, continuing to put all of our lives in danger.

The common thread behind the record-breaking measles spread currently in the US? It isn’t malnutrition—it’s not being vaccinated.

In the Texas-New Mexico outbreak, only 2 measles cases currently reported were among vaccinated individuals (because nothing is 100% effective, so let’s cease and desist with the expectation that any divergence from that in the context of vaccines constitutes a failure of vaccines).

First, a quick virology refresher. Measles is caused by the highly contagious Measles morbillivirus (MeV), an RNA virus in the Paramyxovirus family. It is spread through aerosol and airborne respiratory droplets, and can remain in the air for hours after an infected person leaves a room. It is the most contagious human pathogen: in an unvaccinated population, one person with measles can infect up to 18 others (this is called the R0). That’s why before vaccines, it ripped through populations, infecting nearly every child by age 15. (For context, COVID-19 at the start of the pandemic had an R0 of 2.5).

Before measles vaccines, the virus caused millions of cases and thousands of deaths every year in the US alone. Globally, measles caused an average of 2.6 million deaths every year. After the introduction of measles vaccines in the 1960s, global measles deaths plummeted by more than 94%, to roughly 140,000 deaths globally in 2018.

In the US, the approval and deployment of measles vaccines (starting in 1963) FDA approval of the first measles vaccine in 1963 followed by the updated formulation in 1971 led to a 99% reduction in measles cases in less than 20 years.

To be absolutely clear: vaccines—not nutrition—caused that drastic decline.

RFK Jr manipulates data to push a false narrative undermining measles vaccines

RFK Jr. and his Children’s Health Defense allies, and the anti-vaccine group “Physicians for Informed Consent” frequently circulate charts like below, displaying measles death rates declining prior to the introduction of vaccines. This is their “proof” that measles is prevented by hygiene and nutrition, not vaccination.

Physicians for Informed Consent, PUBLISHED by Business Insider, December 2024.

Charts like these are incredibly misleading, and they completely omit the big picture—a common tactic among anti-science activists spreading clickbait.

First, this is a chart of mortality rate–not measles cases.

Vaccinations DO prevent death, reduce disease severity. However, in the case of the measles vaccine, first and foremost, it reduces infections and illness. And you can see in the first figure included here that cases of measles dropped following the introduction of the measles vaccine in 1963.

Why do they only present mortality rates? Well, because if they presented measles cases, their argument that the vaccine does nothing would fall apart.

But let’s talk about the mortality rate data. Death due to infectious diseases are a result of damage caused by the pathogen, right?

Measles is a viral infection, so in the absence of antivirals, treatment once someone is sick aims to provide supportive care – to mitigate complications and symptoms of illness so that the person who is sick can potentially recover and heal.

The leading causes of death from measles are:

Pneumonia
Encephalitis and brain damage
Diarrhea and dehydration

These symptoms occur as the measles virus replicates in your body, spreads systemically, and causes damage to your cells, tissues, and organs (more here on that).

Pneumonia is a lung infection that causes inflammation of the air sacs (alveoli) that extract oxygen from the air (and excrete carbon dioxide as waste). Pneumonia causes difficulty breathing, pus and fluid buildup, and reduced oxygenation of your blood (and organs). As this worsens, and without supportive care, this can lead to respiratory failure and death.

Pneumonia can be caused directly by measles virus or by secondary bacterial infections as your body is weakened by the measles virus.

When someone has viral pneumonia, like with measles, supplemental oxygen can prevent the rapid decline and respiratory failure and give your body time to heal. Guess when supplemental oxygen became widely used for medical care? 1917. Absolutely, the development of that supportive care measure was critical for improving outcomes once people were severely ill.

Secondary bacterial infections that cause pneumonia are a leading cause of death for many respiratory viral diseases, including influenza, RSV, and others. The first antibiotic, penicillin, became widely available to the American public following World War II, in 1945. Antibiotics are useless for viruses, but if measles-associated pneumonia was exacerbated by a secondary bacterial infection, antibiotics drastically improve survival.

So yes, improved access to healthcare in the US did improve outcomes due to measles before vaccines existed. That’s why when we discuss mortality rates due to viral illnesses like measles, we stratify based on the income and health infrastructure of the given country. Measles mortality rates range from 0.1% to over 10% — based on access to supportive care. This is why. If you’ve got money and access to healthcare, you will have better health outcomes. That’s true now, that was true 50 years ago.

But those interventions weren’t stopping measles.

Measles CASES did not start to drop until we had a way to prevent infection in the first place. Prevent infection? Prevent illness. Prevent illness? Prevent more serious illness or death. That method? It’s called the measles vaccine.

In the graphs he and his allies like to circulate, they omit that very critical detail.

So I included the key developments below. You see measles case rates are flat—until vaccines become available in 1963. Vaccination reduced the number of cases. And guess what? Vaccination allowed the US to be declared free of endemic measles in 2000, a status we have likely lost (who is the authority on that declaration?)

RFK Jr. conflates mortality rates (deaths per infection) with incidence rates (how many people actually get sick). This is intentional—to undermine the single intervention that stopped measles in its tracks.

Vitamin A is not improving measles outcomes in high income countries

RFK Jr. has repeatedly claimed, "If people were sufficiently nourished—especially with vitamin A—measles wouldn't exist." In fact, he has suggested that He cites studies that show vitamin A supplementation can reduce measles-related deaths. Like most pseudoscience, there's a grain of truth twisted into a misleading narrative:

Vitamin A supplementation is associated with a reduced risk of death—but only in children who are already infected and severely deficient.

A widely-cited Cochrane review shows modest reduction in risk of death from measles from vitamin A supplementation in children younger than 2 years old who are hospitalized with severe illness and are vitamin A deficient.

If that sounds like a lot of caveats, you’re right. There are more.

A single megadose of vitamin A did not improve outcomes.
Risk of death and risk of pneumonia-specific death were reduced with 2 sequential megadoses of Vitamin A in countries where mortality rates due to measles are over 10%, due to health inequities.
Vitamin A supplementation did not reduce risk of developing pneumonia or developing diarrhea, both leading causes of death due to measles.
The overall analysis (when all included studies were pooled) did not find a significant reduction in mortality with vitamin A supplementation in children with measles.
There is limited information of overall baseline nutrition status of these patients, and sample sizes were generally low.

Another caveat? The authors are explicit that these findings are only relevant to low-income countries where vitamin A deficiency is widespread.

This is supported by another large meta-analysis inclusive of over 1 million children, which found a modest (12%) reduction in the risk of death due to measles with Vitamin A supplementation in low income countries.

Studies assessing potential benefits of vitamin A supplementation for measles in high income countries like Italy have found no benefit.

The most important detail? Vitamin A supplementation does not prevent measles infection.

You still get measles if you inhale the virus. No amount of carrots or supplements changes that.

What actually prevents measles? The MMR vaccine.

2 doses of the MMR vaccine is 97% effective at preventing measles infection and illness if you are exposed to the measles virus.

On the flip side?

Zero vaccines doses + measles virus exposure gives you a 90% chance of infection.

Measles outbreaks are occurring in communities that don’t have high enough vaccine rates — not those that are malnourished.

If measles were primarily about nutrition, we wouldn’t see outbreaks in well-nourished communities. But we do.

The 2018-2019 measles outbreak in New York saw 649 cases, primarily among affluent, well-nourished individuals.
- The common thread? Not being vaccinated. 85.8% of cases were among unvaccinated children. Malnutrition wasn’t the issue: refusing vaccines was.
An outbreak in Ohio in 2014 among Amish communities saw 383 measles cases, also among well-nourished individuals. 89% of cases were among unvaccinated individuals. Malnutrition wasn’t the issue: refusing vaccines was.

Vitamin A is an important micronutrient—as many are. Legitimate nutrient deficiencies can reduce overall health and negatively impact immune system function. No credible scientist or healthcare provider would dispute that. In fact, we understand how these different chemicals (yep, these are chemicals too) play a role in our physiology. But Vitamin A deficiency in the US is incredibly rare. Less than 0.3% of the US population has vitamin A deficiency.

And just like everything, there is too much of a good thing. Vitamin A is a micronutrient that is easy to overdose on, because it is fat-soluble. That means it is stored in your tissues, even if you ingest too much of it, and you don’t excrete it in your urine quickly, as you might a water-soluble one like Vitamin C.

Vitamin A toxicity can be acute or chronic — symptoms include nausea, vomiting, headache, dizziness, irritability, blurred vision, hair loss, rashes, cracked skin and lips, loss of muscle coordination, liver damage, even death.

In fact, rates of vitamin A toxicity in the US are higher than rates of vitamin A deficiency.

RFK Jr’s rhetoric may convince people to overdose on vitamin A instead of getting vaccinated for measles.

Not only will this not prevent, treat, or cure measles, but it has serious consequences associated with overdose. RFK Jr. and others who are promoting wellness pseudoscience are conflating an important distinction: infection versus disease severity — a common tactic among anti-science activists.

Poor nutrition makes infectious diseases worse. That’s true for measles, flu, COVID-19, TB, pretty much every pathogen. That’s because our immune system needs appropriate levels of nutrients to execute wound healing and response actions. But nutrition doesn’t cause these diseases. Pathogens do.

Measles is caused by a respiratory virus that we can prevent with a safe and effective vaccine.

The measles virus doesn’t care how much salad you ate. If you inhale viral particles, their goal is to infect and replicate. Measles vaccination prepares your immune system to fend off those viral particles before they are able to replicate, preventing infection, illness, complications, and death.

The data are clear. The measles vaccine is safe, effective, and is the reason we eliminated measles in the US in 2000. Today, outbreaks only occur when vaccine rates drop below the herd immunity threshold of this incredibly contagious virus.

Nutrition is important but it won’t stop measles

If we abandoned measles vaccination programs:

Plenty of well-nourished people would get infected. Remember, this is the most contagious human pathogen — being in a room 2 hours after an infected person was there can be enough to infect you if you’re unvaccinated.
The measles virus would spread unchecked because people who are not protected through vaccination are susceptible, no matter their nutrition status. Remember, even in those low-income studies, vitamin A supplementation did not prevent infection.
As cases rise, so will the number of severe complications and deaths would skyrocket, especially in those with any underlying health conditions. We’ve already seen 2 deaths during this current outbreak in Texas. That’s 2 more in a month than we have seen in an entire decade.

RFK Jr.’s role as HHS Secretary demands accountability. His wellness rhetoric is dangerous and reckless. Measles resurgence isn't hypothetical—it’s happening right now, driven directly by the vaccine misinformation RFK Jr. himself has promoted—and profited off of—for over 20 years.

RFK Jr. is wrong. Vaccinate yourself and your kids. Protect your community. Don’t fall for wellness grifts dressed up as health advice.

Now, more than ever, we all must join in the fight for science.

Thank you for supporting evidence-based science communication. With outbreaks of preventable diseases, refusal of evidence-based medical interventions, propagation of pseudoscience by prominent public “personalities”, it’s needed now more than ever.

More science education, less disinformation.

- Andrea

ImmunoLogic is written by Dr. Andrea Love, PhD - immunologist and microbiologist. She works full-time in life sciences biotech and has had a lifelong passion for closing the science literacy gap and combating pseudoscience and health misinformation as far back as her childhood. This newsletter and her science communication on her social media pages are born from that passion. Follow on Instagram, Threads, Twitter, and Facebook, or support the newsletter by subscribing below: