Reduced seroconversion to measles in infants given vitamin A with measles vaccination.
Administration of 100,000 IU vitamin A at the time of measles immunisation is currently recommended for infants in developing countries. However, the safety and value of giving vitamin A, a potent immune enhancer, with live measles virus vaccines are unknown. We conducted a randomised, double-blind, placebo-controlled clinical trial in Indonesia to evaluate the effect of simultaneous vitamin A supplementation on the immune response to measles immunisation at six months of age. 336 infants received either vitamin A (100,000 IU) or placebo when immunised with standard-titre Schwarz measles vaccine. 82% of infants seroconverted to measles. In a multiple logistic regression model adjusting for maternal antibody titres, vitamin A supplementation was associated with a lower likelihood of seroconversion to measles (odds ratio 0.40, 95% CI 0.19-0.88), and girls were less likely to seroconvert than boys (0.34, 0.15-0.76). Immunisation with standard-titre Schwarz vaccine at six months of age in this study population is characterised by high seroconversion rates. However, simultaneous high-dose vitamin A may interfere with seroconversion to live measles vaccine in infants with maternal antibody.
Semba
R D
RD
Department of Ophthalmology, International Health, Johns Hopkins University Schools of Medicine, Baltimore, MD 21287, USA.
Munasir
Z
Z
Beeler
J
J
Akib
A
A
Muhilal
Audet
S
S
Sommer
A
A
D000914:Antibodies, Viral / Q000032:analysis / Q000276:immunology*; D004311:Double-Blind Method; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007112:Immunity, Maternally-Acquired / Q000276:immunology; D007214:Indonesia; D007223:Infant; D016015:Logistic Models; D008297:Male; D008457:Measles / Q000276:immunology* / Q000517:prevention & control; D008458:Measles Vaccine; D008459:Measles virus / Q000276:immunology; D010919:Placebos; D012737:Sex Factors; D014611:Vaccination; D014801:Vitamin A / Q000008:administration & dosage / Q000627:therapeutic use*
D000914:Antibodies, Viral; D008458:Measles Vaccine; D010919:Placebos; D014801:Vitamin A