Kennedy draws from misinformation playbook by touting an inhaled steroid to treat measles

The measles outbreak in West Texas has reignited familiar anti-vaccine tactics: claiming there are readily available treatments for the disease while sowing doubt in the safety of vaccines. 

Health Secretary Robert F. Kennedy Jr. on Sunday touted two particular medications that have not been shown to work as first-line treatments for measles: the steroid budesonide and the antibiotic clarithromycin.

Although experts say there are no specific treatments proven to help people recover faster from measles, Kennedy claimed on X that the medications had been instrumental in treating around 300 children in Texas, and told Fox News that doctors prescribing them had seen “very, very good results.” Kennedy has been sharply criticized by medical experts for weeks for spreading misinformation about the measles vaccine and failing to encourage parents to vaccinate their children. (He has since said that the vaccine is the most effective way to prevent the spread of measles, and on Wednesday said that people should get it.)

Since January, measles has taken off in a primarily Mennonite community in Gaines County, Texas, where vaccine hesitancy is prevalent. Families in the community have turned to questionable remedies like budesonide to treat their illnesses — in some cases, at the recommendation of two Texas doctors, Dr. Ben Edwards and Dr. Richard Bartlett. 

On Sunday, Kennedy called Edwards and Bartlett “extraordinary healers” who have “treated and healed” hundreds of children with budesonide and clarithromycin, sharing a photo of himself and the doctors with three Mennonite families whose children had become ill. Two of the families had each recently lost a daughter to measles: 6-year-old Kayley Fehr died in February and 8-year-old Daisy Hildebrand died last week. Neither child was vaccinated.

Edwards, a conventionally trained doctor who has shifted to promoting natural remedies and prayer, has been operating a makeshift clinic in Seminole, offering children these unproven treatments — including, according to a video posted by an anti-vaccine group, while he said he was sick with measles. Edwards has allied himself with the anti-vaccine movement in recent months, hosting influencers and activists on his podcast, including Barbara Loe Fisher of the National Vaccine Information Center, Brian Hooker of Children’s Health Defense and Andrew Wakefield, the discredited British doctor behind a retracted study that fraudulently linked autism to the MMR vaccine.

In addition to the two measles deaths in Texas, an adult in New Mexico died in early March. While the death is still under investigation, the individual tested positive for measles after death. There have been 657 measles cases so far this year, the highest total since 2019 when there was a major outbreak in Orthodox Jewish communities in New York, according to NBC News’ tally of state health department data. Most are tied to the Texas outbreak, which has spilled into several neighboring states. The vast majority of patients were not vaccinated or had an unknown vaccination status. 

There are no treatments for measles itself, although children may need medical care to treat complications, such as pneumonia. Because of this, public health experts emphasize the importance of getting two doses of the measles, mumps and rubella (MMR) vaccine, which are 97% effective at preventing the disease, according to the Centers for Disease Control and Prevention. 

“There is no evidence to support the use of either aerosolized budesonide or clarithromycin for treatment of children with measles,” said Dr. Adam Ratner, a spokesman for the American Academy of Pediatrics.

Prescribing treatments that have not been vetted in clinical trials amounts to experimenting on patients, added Dr. Susan McLellan, a professor in the infectious diseases division at the University of Texas Medical Branch.

“It is very understandable that people want to grasp onto a hopeful remedy,” McLellan said. “It is unfortunate when trusted providers of advice, such as those in higher levels of our government, are not very clearly stating what is upheld by scientific evidence and what is not.”

A spokesperson for the Department of Health and Human Services said Kennedy has offered clear guidance that vaccines are the most effective way to prevent measles.

Edwards declined to comment. Bartlett did not respond to requests for comment.

The misinformation playbook

During the Covid pandemic, fringe doctors hyped unproven cures like ivermectin — an antiparasitic drug typically used for worm infections — while making unsubstantiated claims about the dangers of mRNA shots. Kennedy himself told podcaster Joe Rogan in 2023 that ivermectin was discredited because various groups stood to make money off Covid vaccines.

Edwards and Bartlett, the doctors treating measles patients in Texas, have a similar history of questioning vaccine safety. Edwards shared dubious claims about injuries and deaths related to Covid vaccines at a Texas state legislative hearing in 2021. And Bartlett touted budesonide as a “silver bullet” to treat Covid during the pandemic.

During the measles outbreak, they have each warned of risks associated with the MMR vaccine: Edwards claimed, falsely, that it causes “potentially” hundreds of deaths a year and Bartlett has said that the complications caused by measles, including brain swelling and pneumonia, can also be caused by the vaccine. In reality, the MMR vaccine, which is only given to children with healthy immune systems, has been overwhelmingly safe since its approval more than five decades ago, and has saved an estimated 94 million lives worldwide. Some people may experience temporary side effects such as a fever, rash or joint pain, which are expected after vaccination.

Measles, on the other hand, is highly contagious and can be life-threatening for the unvaccinated. On average, measles kills almost 3 out of every 1,000 people diagnosed. 

But anti-vaccine activists have tried to link the two recent pediatric deaths to medical malpractice instead, which NBC News could not verify. On an episode of Edwards’ podcast, “You’re the Cure,” on Monday, Bartlett attributed at least one measles death in the U.S. to “medical error,” claiming that a child had not been treated with the appropriate antibiotic for a secondary bacterial infection.

Covenant Children’s Hospital, which treated the first child who died, called such claims circulating online “misleading and inaccurate.” University Medical Center Children’s Hospital, which treated the second child, said in a statement Sunday that the patient had no known underlying health conditions and was receiving treatment for complications of measles while hospitalized.

Dr. Robert Malone, an anti-vaccine activist, similarly suggested in his newsletter over the weekend that the two pediatric deaths were due to medical error, and that budesonide could have saved at least one child’s life. 

What the science actually says

Budesonide is normally used to treat inflammatory diseases. In capsule form, it’s an effective treatment for Crohn’s disease. And its inhaled form can reduce asthma symptoms. 

Bartlett said on Edwards’ podcast that he realized, through divine intervention in March 2020, that budesonide could help save the lives of people who were critically ill with Covid. 

“While I was asleep, an answer to prayer came to me,” he said. “It will shut down the release of the cytokines, the inflammatory chemicals from the lung lining.”

He pointed to trials out of the University of Oxford that he said supported that claim. The trials showed that budesonide could shorten recovery times in nonhospitalized patients, but there’s no firm evidence that it can reduce the risk of hospitalization or death from Covid. 

Steroids should not be given early in the course of a viral infection like measles, because they inhibit the immune system, said Dr. Paul Offit, director of the Vaccine Education Center at Children’s Hospital of Philadelphia.

“That’s not what you want to do,” he said. “Your immune system works for you” to fight measles.

Doctors do use steroids in people with Covid who have late-stage pneumonia if their immune system has become overactive, Offit said. 

Doctors prescribe budesonide, administered by either an inhaler or nasal spray, to reduce wheezing in people with asthma, he added. While people with measles develop a cough, they don’t really wheeze.

Kennedy’s suggestion that measles patients could benefit from clarithromycin similarly lacks context, pediatricians and infectious disease doctors said. 

Antibiotics are designed to kill bacteria, not viruses, so they don’t work against measles itself. But measles can weaken the body so much that people develop a bacterial infection such as staphylococcus or streptococcus. 

Offit said doctors typically treat such infections with a combination of antibiotics called vancomycin and ceftriaxone. These medications are given intravenously, he said, whereas clarithromycin usually comes in pill form. Studies show it’s more effective to treat severe infections, such as bacterial pneumonia or sepsis, with intravenous antibiotics, which help ensure that adequate levels of the antibiotics make it into the bloodstream. Patients who take antibiotics by mouth may not receive a high enough dose to combat a serious infection, because the medication has to go through the intestines, where it may not be fully absorbed.

“You don’t treat severe infections orally,” Offit said. “It would be too risky.”

Clarithromycin is also a broad-spectrum antibiotic, meaning it targets a wide range of bacteria, said Dr. Paul Kilgore, a professor at Wayne State University’s Eugene Applebaum College of Pharmacy and Health Sciences.

“If we treat with broad-spectrum antibiotics, we don’t know exactly what we’re treating [and] we run the risk of increasing antibiotic resistance,” he said.

Public health experts said touting these medications as first-line treatments sends the wrong message. 

“By mentioning such treatments without that context, RFK Jr. continues to distract away from the prevention measure that incontrovertibly works — the vaccine,” said Dr. Amesh Adalja, a senior scholar at the Johns Hopkins Center for Health Security.

This article was originally published on NBCNews.com