Effect of vitamin A supplementation on measles vaccination in nine-month-old infants

Semba, Richard D.; Akib, Arwin Ap; Beeler, Judith; Munasir, Zakiudin; Permaesih, Dewi; Muherdiyantiningsih,; Komala,; Martuti, Sri; Muhilal,

doi:10.1038/sj.ph.1900366

Cited by 16 publications

(13 citation statements)

References 4 publications

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“…Similar results were found in children having low maternal antibodies at baseline; the VA impact could not be assessed in children with high maternal antibodies, because the number of such children was too small (n ¼ 5). However, 3 other RCT conducted in India and Indonesia did not show any effect of VA on seroconversion to measles vaccination given at 9 mo of age; these seroconversion rates were globally high in both the supplemented and control groups (86)(87)(88). Moreover, a clinical trial in Bangladesh assessed the effect of VA supplements on MV response when administered near to vaccination or not.…”

Section: Va and Vaccine Responsesmentioning

confidence: 88%

“…Based on 3 studies in which this information was available (81,85,87), we found that VAS was associated with reduced seroconversion rates in children having high baseline antibody levels [OR (95% CI) ¼ 0.57 (0.35-0.94); P ¼ 0.03] (Fig. 4).…”

Section: Va and Vaccine Responsesmentioning

confidence: 92%

“…Our meta-analysis of these studies (81,83,(85)(86)(87)(88)(89) revealed that VAS did not affect MV response when given at 6 or 9 mo of age [odds ratio (OR) (95% CI) ¼ 1.08 (0.81-1.45); P ¼ 0.59] (Fig. 2).…”

Section: Va and Vaccine Responsesmentioning

confidence: 94%

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Landscape Analysis of Interactions between Nutrition and Vaccine Responses in Children

Savy

Edmond²,

Fine³

et al. 2009

The Journal of Nutrition

129

146

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The world's poorest children are likely to be malnourished when receiving their childhood vaccines. It is uncertain whether this affects vaccine efficacy and whether the coadministration of nutrient supplements with vaccines has beneficial or detrimental effects. More recently, a detrimental interaction between vitamin A (VA) supplementation (VAS) and the killed diphtheria-tetanus-pertussis vaccine given in early childhood has been suggested. This report provides a critical review of the published interactions between nutritional status and/or supplementation and vaccine responses in children. Due to an absence of evidence for most nutrients, this analysis focused on protein-energy, vitamins A and D, and iron and zinc. All vaccines were considered. Both observational studies and clinical trials that led to peer-reviewed publications in English or French were included. These criteria led to a pool of 58 studies for protein-energy malnutrition, 43 for VA, 4 for vitamin D, 10 for iron, and 22 for zinc. Our analysis indicates that malnutrition has surprisingly little or no effect on vaccine responses. Evidence for definitive adjunctive effects of micronutrient supplementation at the time of vaccination is also weak. Overall, the paucity, poor quality, and heterogeneity of data make it difficult to draw firm conclusions. The use of simple endpoints that may not correlate strongly with disease protection adds uncertainty. A detailed examination of the immunological mechanisms involved in potential interactions, employing modern methodologies, is therefore required. This would also help us understand the proposed, but still unproven, negative interactions between VAS and vaccine safety, a resolution of which is urgently required.

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Section: Va and Vaccine Responsesmentioning

confidence: 88%

Section: Va and Vaccine Responsesmentioning

confidence: 92%

See 1 more Smart Citation

Landscape Analysis of Interactions between Nutrition and Vaccine Responses in Children

Savy

Edmond²,

Fine³

et al. 2009

The Journal of Nutrition

129

146

View full text Add to dashboard Cite

show abstract

“…24 However, studies reported from India and other countries have demonstrated that such a schedule is not only safe and effective, but also feasible. 16,[25][26][27][28]…”

Section: Immune Adjuvant Effects Of Vitamin Amentioning

confidence: 99%

Micronutrient Malnutrition, Infection, and Immunity: an Overview

2002

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Micronutrient deficiencies and infectious diseases often coexist and exhibit complex interactions leading to the vicious cycle of malnutrition and infections among underprivileged populations of the developing countries, particularly in preschool children. Several micronutrients such as vitamin A, beta-carotene, folic acid, vitamin B12 vitamin C, riboflavin, iron, zinc, and selenium, have immunomodulating functions and thus influence the susceptibility of a host to infectious diseases and the course and outcome of such diseases. Certain of these micronutrients also possess antioxidant functions that not only regulate immune homeostasis of the host, but also alter the genome of the microbes, particularly in viruses, resulting in grave consequences like resurgence of old infectious diseases or the emergence of new infections. These micronutrient infection and immune function interactions and their clinical and public health relevance in developing countries are briefly reviewed in this article.

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“…Childhood immunization programs in developing countries involve an estimated 500 million child contacts per year, and it has been suggested that the infrastructure of these programs could be used to distribute vitamin A capsules and/or oral iodized oil capsules (9). The integration of high-dose vitamin A supplementation with childhood immunization programs does not appear to interfere with seroconversion to live trivalent oral poliovirus vaccine when given at 6, 10, and 14 wk of age (10) or to measles vaccine when given at 9 mo of age (11)(12)(13). Vitamin A supplementation does not appear to reduce measles or diarrheal morbidity or mortality for infants under 6 mo of age (14,15).…”

mentioning

confidence: 99%

Integration of vitamin A supplementation with the Expanded Programme on Immunization: lack of impact on morbidity or infant growth

Munasir

Akib

et al. 2001

Acta Paediatrica

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Vitamin A deficiency is associated with increased morbidity and mortality from diarrheal disease, measles, and malaria. It has been proposed that vitamin A supplementation could be linked with childhood immunization programs to improve child health. We conducted a randomized, double‐blind, placebo‐controlled clinical trial to evaluate the impact of linking vitamin A supplementation with the Expanded Programme on Immunization on morbidity and child growth. In West Java, Indonesia, 467 six‐week‐old infants were randomized to receive 7.5 mg retinol equivalent (RE), 15 mg RE, or placebo with childhood immunization contacts at 6, 10, and 14 wks and 9 mo of age. Child growth was assessed through anthropometry, and morbidity histories were obtained. Vitamin A supplementation had no apparent impact upon linear or ponderal growth or infectious disease morbidity in the first 15 mo of age when integrated with the Expanded Programme on Immunization. Conclusion: Although improving vitamin A nutriture is of general importance in reducing diarrheal and measles morbidity and mortality in developing countries, this clinical trial showed no apparent benefit of vitamin A capsules for infant health when given through childhood immunization programs.

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Effect of vitamin A supplementation on measles vaccination in nine-month-old infants

Cited by 16 publications

References 4 publications

Landscape Analysis of Interactions between Nutrition and Vaccine Responses in Children

Landscape Analysis of Interactions between Nutrition and Vaccine Responses in Children

Micronutrient Malnutrition, Infection, and Immunity: an Overview

Integration of vitamin A supplementation with the Expanded Programme on Immunization: lack of impact on morbidity or infant growth

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