As the outbreak rages, unproven remedies like cod liver oil are being distributed free by some doctors. Families are lining up for them.

SEMINOLE, Texas — The building where hundreds of families are lining up for measles care amid a fast-growing outbreak in West Texas looks more like an abandoned car dealership than a doctor’s office. There’s no signage, nothing saying “Open” or indicating office hours.

But nearly every day, dozens of pickup trucks from all over Gaines County fill the parking lot, squeezing into any available space.

Inside the building — a “barndominium” in West Texas parlance — there’s a handful of tables and chairs set up. Sick families, mostly Mennonite, sit in a makeshift waiting room on the far left, and Dr. Ben Edwards is at a table on the far right.

One by one, families are called over to meet with the doctor.

Edwards asks about their diet and nutritional intake but does not do bloodwork to look at levels of specific vitamins or nutrients. Based on the conversations with the parents and the child, he decides whether the patient might benefit from cod liver oil, which is high in vitamins A and D. Bottles of the product — offered at no charge — line tables in the room.

If kids are having significant trouble breathing, Edwards recommends budesonide, an inhaled steroid typically used for asthma.

He does not offer vaccines.

Gaines County, where Seminole sits, has one of the state’s highest vaccine exemption rates, at nearly 18%, compared to 3% nationally. The embrace of unproven remedies shows that many members of the community are also eschewing conventional medical approaches.

Seminole is the county seat of Gaines County, Texas, the center of the measles outbreak.Annie Rice for NBC News

“We need to help these kids out,” said Edwards, a family physician based an hour away in the city of Lubbock. Part of that help, he said, is by supplying kids and their families with cod liver oil and nutrition information, “like Bobby Kennedy is trying to do.”

Edwards is, of course, referring to newly confirmed Health and Human Services Secretary Robert F. Kennedy Jr., who’s been vocal against proven medical practice. He’s encouraged vitamins and cod liver oil over vaccination and isolation to control the outbreak.

There’s no antiviral or cure for measles. Kids sick enough to be hospitalized are often given oxygen to help with their breathing. Studies done in other countries have suggested that vitamin A may be helpful in treating malnourished children with the disease. There’s no credible evidence to suggest cod liver oil is effective.

Though doctors here can administer vitamin A for measles, it’s typically used for severe cases in the hospital. Most people in the U.S. have normal levels of the vitamin and don’t need extra.

Too much can be toxic, said Dr. Ronald Cook, chief health officer at the Texas Tech University Health Sciences Center in Lubbock and health authority for the city. “Before I’d give mega doses of vitamin A, I would certainly get a vitamin A level” in the blood, he said.

Any messaging suggesting that vitamin A, including cod liver oil, could be an alternative to vaccination is “misleading,” said Dr. David Higgins, a pediatrician and preventive medicine specialist at the University of Colorado Anschutz Medical Campus. “The goal is to prevent measles from ever occurring. Every single illness, hospitalization and death [from measles] is entirely preventable with vaccines.”

Edwards said that he’s spoken with Kennedy about how he’s treating measles cases, but said he didn’t know him and wasn’t involved with the anti-vaccine group Kennedy founded, Children’s Health Defense, before the outbreak began several weeks ago. Both, however, have long advocated against vaccines.

The makeshift clinic and unproven treatments in Texas echo a different deadly measles outbreak in which Kennedy was involved. In 2019, as measles raged in Samoa, Kennedy, then chairman of Children’s Health Defense, connected alternative medicine doctors in the U.S. with a local self-described “natural healer,” who administered their vitamin protocols to sick children and spread fear over the Pacific Island nation’s vaccination campaign. A total of 83 people, mostly children, died in the outbreak. Kennedy has repeatedly denied any involvement in the deaths and questions whether they were caused by measles at all.

As of Friday, the Texas Department of State Health Services reported 198 confirmed cases of measles in West Texas, mainly in Gaines County. Across the state border, in Lea County, New Mexico, 30 cases have been reported.

Twenty-three people — mostly unvaccinated children — have been hospitalized in West Texas, per state data. Two people have died, a 6-year-old in Gaines County and an adult in Lea County who tested positive for measles after death.

News of the child’s death — the first child in the U.S. to die of measles in over two decades — was met with skepticism from anti-vaccine activists. On last Friday’s edition of the Children’s Health Defense internet morning show, the group’s chief scientific officer, Brian Hooker, repeated false claims that have been spreading on social media that the child had actually been sick with RSV and pneumonia, and denied proper treatment in the hospital.

“It’s really nefarious,” Hooker said. “It feels like Covid all over again.”

Edwards hosted Hooker on his podcast in February, about a month into the Texas outbreak.

“Offering nontraditional therapies to individuals who look for something other than science-based or evidence-based medicine makes it really hard to convince that group that my science is better than his science,” Cook said.

A turn away from conventional medicine

Edwards was conventionally trained at the University of Texas-Houston Medical School and initially opened a small town clinic where he practiced family medicine.

In recent years, however, he’s made a switch to practicing outside of conventional medicine, operating as a so-called integrative practitioner or functional medicine doctor and promoting something he called the “Four Pillars of Health” as the key to health: nutrition, hydration, movement and peace. Through his website, Edwards sells dietary supplements, blood tests, and $35-a-month membership plans for access to his online education materials.

Edwards told NBC News that he’s volunteering his time in the measles outbreak.

Dr. Ben Edwards in 2009.The Washington Post via Getty Images file

During Covid, Edwards appeared as an expert at Texas state legislative hearings, where he shared dubious claims about widespread injuries and deaths he said were caused by the vaccines. In 2020, Edwards said that masks were ineffective.

On recent podcast episodes, Edwards said that after practicing for several years, he came to believe that vaccines and modern medicine were not responsible for historical declines in infectious disease deaths. Instead, he credited sanitation, nutrition and other lifestyle factors — factors that were instrumental in decreasing mortality, but do not account for how vaccines have reduced or eliminated infectious diseases.

On his podcast, he’s hosted anti-vaccine influencers and activists, including Barbara Loe Fisher of the National Vaccine Information Center and Hooker of Children’s Health Defense; defended Andrew Wakefield, the discredited doctor behind the retracted study that falsely linked autism to the MMR vaccine; and recommended books from anti-vaccine activist J.B. Handley and the 2016 anti-vaccine film, “Vaxxed.”

A community approach

The full scale of the measles outbreak in West Texas isn’t captured by official reports.

Edwards did a quick tally of the number of cases he’s seen at the warehouse in Seminole: approximately 188 in the last week. That estimate is based on symptoms alone, without confirmatory testing. It’s unclear how much overlap there is between his estimates and the official Texas numbers.

The number of hospitalizations is also outpacing the state’s official count. Covenant Children’s Hospital in Lubbock has treated 36 measles cases, said hospital spokesperson Meredith Cunningham.

Katherine Wells, director of public health at the Lubbock Health Department, said her worry level about the outbreak is “at a 10.”

“The longer it goes on, the more likely we are to have people travel from one community to another and start an outbreak in another area,” she said.

Measles is one of the most contagious viruses on the planet. Viral particles can hang in the air for up to two hours and infect unvaccinated, vulnerable people. Large indoor gatherings are ripe for superspreader events.

Edwards said he wasn’t concerned about patients congregating in his Gaines County clinic because “they were all sick with measles.”

A nearby health food store called Health 2 U is also a gathering place for members of the community. Cod liver oil is given out, sometimes for free, thanks to donations.

“The cod liver oil is being given away at no cost to anybody,” Edwards said. “The local community and folks from across the country are donating to help pay for that.”

On Thursday, a steady stream of parents entered the store seeking advice for their kids sick with measles — including a woman carrying a little girl wrapped in a blanket. She was limp, with blotchy spots on her skin and a dazed look in her eyes that any parent knows means, “I don’t feel good.”

The scene is worrisome to doctors, who generally advise that parents call their pediatricians before taking kids who may have been infected into public places.

Tina Siemens, a local historian in Gaines County who has assisted Edwards in the clinic, pushed back against the notion that the Mennonites in the area are uneducated about the disease or their decision not to vaccinate.

“These mamas, these daddies, they do their reading. They have made that choice based on what they read,” Siemens said. “To paint everyone with the same wide brush stroke is a misrepresentation of our amazing community.”

A measles expert from the Centers for Disease Control and Prevention personally met with Siemens on Friday, she said, to learn more about vaccine attitudes in the community, while also encouraging the shots.

Despite overwhelming evidence that the measles-mumps-rubella vaccine is safe, both Edwards and Kennedy insist that families should decide for themselves whether to get their kids the shots or not. That’s widely applauded in Gaines County.

Folks in Seminole bristle at questions about whether they vaccinate their children. A group of moms gathered at a coffee shop recently did not want to speak on the record, offering this message instead: “Mind your own business.”