Enhancement in seroconversion to measles vaccine with simultaneous administration of vitamin A in 9-months-old Indian infants

Abstract

The mutual interactions of measles vaccine and vitamin A dose when administered simultaneously to 9 month old infants are explored in this study. One hundred healthy infants of 9 months of age received EZ strain of measles vaccine in the routine immunization clinic along with either 100,000 IU of vitamin A or a placebo orally. Blood samples were collected before and 4 weeks after intervention. They were coded and analysed for serum retinol and Hemagglutination Inhibition (HI) antibodies to measles. Ninety five per cent of the infants were seronegative to measles prior to vaccination with a seroconversion rate of 63% in the control group and a significantly higher percent of 83.7% in the experimental group (P < 0.01). Seroconversion was not related to initial serum retinol levels in either of the groups. 42% of infants had serum retinol levels less than 20 ug/dl before administration of the vaccine and both the groups showed improvement in vitamin A status following intervention, the increase being significant in the experimental group (from 22.4 +/- 1.32 to 26.0 +/- 1.07; P < 0.05). The results indicate that majority of the infants at 9 months of age were seronegative to measles. Seroconversion to measles vaccine in the routine immunization clinics was low. Simultaneous administration of vitamin A and measles vaccine had beneficial effects on vitamin A status as well as seroconversion rates to the vaccine in 9 months old infants.

Landscape Analysis of Interactions between Nutrition and Vaccine Responses in Children

“…In 6-8-y olds, VAS at 9 mo of age was associated with higher GMT and with higher protection rates against measles (84). In India, the administration of VA to 9-mo-old infants when vaccinated with the Edmonston Zagreb strain MV resulted in significantly higher seroconversion rates 1 mo after vaccination compared with children who were not supplemented, independently of the initial serum retinol levels (85). 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).…”

“…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).…”

The effect of a micronutrient-fortified complementary food on micronutrient status, growth and development of 6- to 12-month-old disadvantaged urban South African infants

“…In the present study, a decline in serum retinol was observed in both groups. The consequences of the potential prevention of decline in serum retinol would positively impact on morbidity (Dudley, 1997;Fawzi et al , 1999;Lartey et al , 2000) and the efficacy of immunisation (Bhaskaram & Rao, 1997), especially in this age group.…”

Recent advances in oral vaccine development

“…Although most studies could not demonstrate an effect of vitamin A deficiency or supplementation on antibody levels in response to vaccination, 50 some clinical and animal studies showed diminished antibody responses. 51,52 Jaensson-Gyllenback et al 53 described that vitamin A deficiency directly impairs intestinal CD103 + dendritic cell function. Retinoic acid (RA), a vitamin A metabolite, has been shown to be a crucial regulator in intestinal immunity and homeostasis by promoting IgA class switch recombination, plasma cell differentiation, and development of regulatory T-cells.…”