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Public Health. 1997 Jul;111(4):245-7.

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

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Department of Ophthalmology, John Hopkins University School of Medicine, Baltimore, MD, USA.



Childhood immunization programs have been suggested as an infrastructure to deliver vitamin A supplements to children in developing countries. The effects of giving vitamin A, a potent immune enhancer, with measles immunization to nine-month-old infants is unknown.


A randomized, double-masked, placebo-controlled clinical trial of vitamin A, 100,000 IU at the time of standard titer Schwarz measles immunization was conducted with nine-month-old infants in Bogor District, West Java, Indonesia. Antibody titers to measles were measured at baseline and one and six months following immunization.


394 infants received measles immunization, and 37 infants (9.4%) had baseline antibody titers > 1:120, which is consistent with previous natural measles infection. Of the remaining infants, 98.8% seroconverted to measles, and 99.3% had titers consistent with protection against measles six months postimmunization. Seroconversion rates were similar in vitamin A and placebo treatment groups.


High dose vitamin A supplementation can be given without reducing seroconversion to standard titer Schwatz measles immunization in nine-month-old infants.


The feasibility of combining vitamin A supplementation and measles immunization was investigated in a double-masked, placebo-controlled clinical trial involving 394 9-months-old infants in Bogor district, West Java, Indonesia. Vitamin A, a potent immune enhancer, has been shown to reduce child mortality by 20-50% in developing countries and is among the most cost-effective child survival interventions. 130 infants received a placebo; 132 were given 25,000 IU of vitamin A at 6, 10, and 14 weeks and 100,000 IU at 9 months; and the final 132 were given 50,000 IU of vitamin A at 6, 10, and 14 weeks and 100,000 IU at 9 months. 37 (9.4%) of the study infants had pre-immunization measles titers greater than 1:120 at 9 months of age, indicative of a previous history of natural measles infection. 98.8% of the remaining infants had seroconverted to measles 1 month after immunization, regardless of whether they received vitamin A or placebo; after 6 months, 99.3% had titers consistent with protection against measles. Geometric mean titers were 1:1772 and 1:2298 at 1 month post-immunization and 1:1164 and 1:1900 at 6 months post-immunization in infants receiving vitamin A and placebo, respectively. Since vitamin A supplementation does not interfere with seroconversion to standard titer Schwarz measles immunization, its inclusion in Expanded Program on Immunization campaigns is recommended.

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