Health officials in Samoa, assisted by international health organizations, have struggled to manage a surge in measles and apparent deaths from measles on the impoverished island since the first laboratory confirmed cases were reported in September 2019. A state of emergency was declared on November 15, and by December 11, 4995 measles cases had been recorded, and 72 people, mostly young children, had died.1
According to RNZ (Radio New Zealand), private citizens from Australia, New Zealand and the United States sent doses of vitamin A to the beleaguered country as treatment for those who were already infected. The shipments of vitamin A were received by Samoan businessman Edwin Tamasese, who states that the vitamin A treatments worked. “We’re having really good success, like in 16 hours we’re having kids that are lying there looking like they’re going to pass away, and they are weak, but then they get up and start drinking, and start to eat.”2
Vitamin A deficiency is recognized as risk factor for severe measles, and since 1987 the World Health Organization (WHO) and the United Nations International Children’s Fund (UNICEF) have recommended a two-dose Vitamin A treatment to reduce complications of measles.3 4
The U.S. Centers for Disease Control and Prevention (CDC) also endorses the vitamin A protocol for treating measles infections.5 Although cod liver oil, which is high in vitamin A, has long been a folk remedy for measles,6 7 8 Dr. Alfred Sommer, a professor at the Johns Hopkins School of Medicine and the Johns Hopkins Bloomberg School of Public Health, first identified the beneficial role of vitamin A in measles treatment as part of his research on vitamin A and night vision in the 1970’s.9
Dr. Sommers wondered, “Could the vitamin A deficiency that was causing night blindness also be making the children fatally susceptible to mild childhood illnesses like measles and diarrhea?”10 Subsequent research by Dr. Sommers and others has confirmed that vitamin A treatment can mitigate complications of measles, such as blindness, as well as reduce mortality especially in young infants.4 11 12 13 14
But the reaction to the Vitamin A shipments by citizens has been “mixed” according to RNZ, including criticism on social media. The World Health Organization’s Nikki Turner said online misinformation claiming children could be treated with vitamins had “no scientific evidence” behind them, and that such claims were “conning” people from getting correct treatment.2
Scientist Ian Mackay, who specializes in virology at the University of Queensland, said anti-vax rhetoric about vitamin A peddled on social media is “not correct.” The CDC has dispatched a behavioral scientist to the area to help with vaccine related communications, and spokesperson Amy Rowland states that “the first priority is making sure we have healthy vaccine demand.”4
Within Samoa, malnutrition is a “growing health concern, particularly for children.”15 Vitamin A treatment costs two or three pennies per dose9 and unlike vaccines, can be administered easily by parents or other providers because it does not require special training or refrigeration. While the vitamin A shipments by citizens to reduce complications in those with measles infections are disparaged in the press and social media, UNICEF has sent 30,000 vitamin A tablets along with 110,500 doses of measles containing vaccine to the island of Samoa.16
2 Anti-vaxers send vitamin A to Samoa. RNZ Dec. 1, 2019.
3 World Health Organization. Weekly epidemiological record Relevé épidémiologique hebdomadaire. WHO. int Aug. 28, 2009; 35(84): 349–360
4 Al Ja Effectiveness of measles vaccination and vitamin A treatment. International Journal of Epidemiology Mar. 23, 2010; 39(1): i48-i55.
5 Centers for Disease Control and Prevention. Measles (Rubeola). CDC.gov Feb. 5, 2018.
6 Pope S. Cod Liver Oil: Myths and Truths of an Ancient Superfood. The Healthy Home Economist.
7 Guy RA. The History of Cod Liver Oil as a Remedy. Am J Dis Child 1923; 26(2): 112-116.
8 Atkinson K. Cod Liver Oil – A Short History & It’s Benefits. Mind, Body and Soul Nov. 9, 2011.
9 Najera RF. Vitamin A and Measles. The History of Vaccines Mar. 12, 2019.
10 Alfred Sommer, MD, MHS. PBS.
11 The Story of Vitamin A. Johns Hopkins School of Public Health.
12 Sommer A. Vitamin A prophylaxis. BMJ Journals 77(33).
13 D’Souza RM. Vitamin A for treating measles in children. Cochrane Database Syst Rev 2002.
14 Huiming Y, Chaomin W, Meng M. Cochrane review: Vitamin A for treating measles in children. Cochrane Review Sept. 29, 2006.
15 Michaels. Malnutrition in Samoa. The Borgen Project June 19, 2015.
16 Pacific Measles Outbreak: UNICEF is supporting the Government of Samoa to respond to a measles outbreak in the country. ReliefWeb Nov. 19, 2019.