The six-year-old girl at the children’s hospital in Lubbock, Texas, burned with fever and struggled to breathe. Doctors soon put her on a ventilator, snaking a thick tube down the child’s throat so a machine could breathe for her; they placed IVs to rehydrate her tiny body and they prescribed antibiotics for any bacterial infections that may have taken hold in the weeks she had spent at home battling measles.

But it was too late. Within a day of being ventilated, the child went into shock, her blood pressure crashed and she went into cardiac arrest. She could not be resuscitated. Her family, and the nation, mourned: she was the first child to die of measles in the US in a decade.

Yet some anti-vaccine activists soon began claiming that the girl died from medical malpractice, not measles, revealing a playbook that they are now running in Pennsylvania amid a growing outbreak – a message taken up by Robert F Kennedy Jr, secretary of the US Department of Health and Human Services (HHS) and a longtime anti-vaccine activist, as he publicly disputes the rising death toll.

The deaths in the US from measles – now numbering eight in less than two years – are a political minefield for Kennedy, centering him in a public backlash after years of his false claims about the measles, mumps and rubella (MMR) vaccine.

The deflection campaign is already having real-world consequences beyond the rising body count. Children’s Health Defense, the anti-vaccine group previously led by Kennedy, claims to have sparked malpractice investigations into the doctors who treated the two young unvaccinated girls who died from measles amid last year’s outbreak in west Texas, which infected at least 762 people.

“At first they were going to throw out the complaints,” Brian Hooker, CHD’s chief scientific officer, announced in a recent video. “But they have, upon further review … decided that they’re going to let their own medical expert look at the records for those particular deaths. Because in each case, inappropriate antibiotics were prescribed, and that, I believe, led to both girls’ deaths.”

Paul Offit, an infectious diseases pediatrician and internationally recognized vaccine expert, said “it’s not a good look” for Kennedy and other anti-vaxxers for so many cases and deaths to rise. “So they’re trying to say, ‘Well, it wasn’t measles.’”

Katherine Wells, Lubbock Public Health’s director, agreed. “It’s their playbook,” she said. “It’s just another tactic by them to disrupt or to question vaccines and the safety of vaccines. The issue at hand is that we’re having these large measles outbreaks, and they’re not stopping.”

It’s not just the deaths – it’s also the severe disease, Wells said. The “massive” outbreaks affect “families and communities and disrupt lives”, Wells said. About one in five unvaccinated measles patients are hospitalized. Measles erases immunity to all other illnesses for years, putting patients at risk of other serious infections. And survivors may years later develop severe measles complications such as subacute sclerosing panencephalitis (SSPE), which is fatal and untreatable.

Last year, Hooker traveled to Texas to interview the deceased six-year-old’s parents, who said they still would not have vaccinated their children. A second child, aged eight, soon died from measles at the same hospital.

Hooker asked to see the children’s medical records, and he shared them with Pierre Kory, a critical care physician with no pediatric training who lost his board certifications for promoting Covid misinformation, heavily promoted the anti-parasitic ivermectin as a Covid treatment, and claimed that polio paralysis is caused not by the virus but by pesticides. Kory, who himself escaped legal liability in a malpractice lawsuit brought by the estate of a Covid patient who died as a result of his treatment plan, concluded that the measles deaths were actually the result of medical error.

Kory claimed the first child was prescribed “a completely inappropriate antibiotic” for a bacterial infection she developed because of measles, adding that “she did not die of measles by any stretch of the imagination,” but rather she died of pneumonia and medical mismanagement. He also attributed the second child’s death to “medical malpractice” because of her antibiotic regime. Secondary bacteria infections are very common with measles, which can create a cascade of deadly complications.

Privately, Kory reportedly said that he suspected the two deaths in young girls in Texas were caused by a weaponized version of measles.

Hooker and a colleague both submitted complaints to the Texas medical board alleging that the antibiotics were given improperly to the sick children. In the video, he said the medical board is reviewing the complaints. The Guardian and Important Context were unable to confirm Hooker’s claims. The identities of the doctors are not public.

Anyone can file a complaint with a state medical board, and boards take complaints seriously. Several leading anti-vaccine figures have received medical board complaints about their own conduct.

“The physicians went above and beyond, and the hospitals went above and beyond,” Wells said. Pediatricians in hospitals work with the sickest children, with high stress and relatively low pay. “It’s so hard to be told that you either wanted to hurt them or didn’t want to give the best care you could,” Wells said. Now, with the CHD accusations and possible medical board reports, “I think it’s in the back of everybody’s minds,” she said.

Hooker’s remarks about the Texas complaints followed the measles deaths of two unvaccinated infants in Pennsylvania. Hooker vowed to “get boots on the ground” in the state to “make sure that if it was a hospital error that it doesn’t happen again”.

Other anti-vaccine activists are helping to fuel the narrative. Peter McCullough, a former cardiologist whose board certification were revoked by the American Board of Internal Medicine, noted on X that there was “no mention of antivirals, antibiotics, or steroids” in the case of the third measles death in Pennsylvania, an unvaccinated 40-year-old woman. Yet the county coroner said the woman was not able to seek healthcare before she took a turn for the worse, so she would not have received medications for her illness.

Kennedy has suggested that Pennsylvania’s governor, Josh Shapiro, made up the measles deaths for political reasons. The message was echoed by Jay Bhattacharya, director of the National Institutes of Health, who claimed in a Fox News interview that Shapiro was “playing this out over the airwaves for political purposes, just like what happened during Covid”, adding: “And this is why there’s such deep distrust in public health.”

Mehmet Oz, administrator of the Centers for Medicare and Medicaid Services, said in a Fox Business interview: “We don’t know if the children died from measles or had another condition that was already attacking them and they happened to get measles at the same time.” The CDC has also called the deaths into question, only listing two of the five deaths this year in Pennsylvania. Officials in Pennsylvania have been clear that the deaths were because of measles.

Anti-vaxxers have long vilified and targeted physicians. In Texas, attorney general Ken Paxton has launched investigations into doctors who vaccinate children, alleging a conspiracy with drug companies. And CHD has funded numerous lawsuits against pediatricians over alleged side effects from vaccines. In January, the group launched a Rico suit against the American Academy of Pediatrics, which had sued Kennedy over changes to the vaccine schedule.

Despite no longer leading CHD, Kennedy still appears to enjoy close ties to the organization. At their Washington DC conference in September, he said they had “a friend in the White House”.

Advocates say the group appears to be running interference for Kennedy amid the ongoing resurgence of measles, which was previously declared eliminated in the US but has made a comeback with rising anti-vaccine sentiment. CHD and Kennedy have been top promoters of vaccine misinformation, according to a 2021 report by the Center for Countering Digital Hate.

Kennedy has been “a very successful anti-vaccine activist”, which has resulted in the largest outbreak of measles in three decades as well as the resurgence of other preventable illnesses, Offit said. “Now we have more children dying of flu and measles and whooping cough – and Haemophilus influenzae type B meningitis is now coming back.”

Anti-vaccine activists want to “distract, distract, distract” from the damage they have caused, Offit said. He believes the tactic will not be successful, pointing to pushback from leaders including Shapiro and from pediatricians. “I think pediatricians will continue to move forward as they have,” Offit said. When Kennedy attempted to slash vaccine recommendations in January, “pediatricians ignored him”, Offit said. “I think most people are ignoring him.”

The efforts to spread misinformation and mistrust about pediatricians may take a toll, especially on people who already doubt vaccines, Wells said. “It just further divides us. It sticks with the people who want to believe that narrative, and I think it adds to the doubt that they have.”

Yet when the outbreaks worsen, people who were previously vaccine-skeptical choose to get them, she said.

“During our outbreak, all the parents that were hesitant came forward as soon as they heard there were cases,” Wells said, “and they got their kids vaccinated.”

This article was written in partnership with Important Context