title: Vitamin a supplementation does not affect infants' immune responses to polio and tetanus vaccines.
abstract: It has been suggested that administering vitamin A with the measles vaccine may reduce the vaccine's immunogenicity. This trial examined the effect of supplementing vitamin A during the early months of life on infants' immune responses to tetanus and polio vaccines. Young infants (n = 1085) were enrolled and individually randomized into 1 of 4 groups in a factorial, double-blind, placebo-controlled trial. Three vitamin A supplementation strategies were investigated: 1) supplementation of breast-feeding mothers with 60 mg retinol equivalent (RE) vitamin A within 4 wk of delivery; 2) Expanded Program on Immunization (EPI)-linked supplementation of infants with 7.5 mg RE vitamin A at 6, 10, and 14 wk; and 3) combined mother and child supplementations. A 4th group in which mother and child were given placebos served as controls. Blood samples were collected from each child at 6 wk and 6 mo of age to measure antipolio antibody titer, antitetanus toxoid antibodies, and avidity of antibodies to tetanus. Of the infants randomized into the 4 arms of the study, 767 (71%) completed follow-up at 6 mo of age. Follow-up rates were similar in all 4 arms (69-72%, P = 0.8). Antibody titers were relatively high in all 4 groups at both 6 wk and 6 mo of age, with no differences among the groups. We found no evidence that vitamin A supplementation affects infants' antibody responses to tetanus toxoid or oral polio vaccine delivered at EPI contacts.
authors.affiliation: Kintampo Health Research Centre, Ghana. sam.newton@ghana-khrc.org
authors.forename: Sam
authors.initials: S
authors.lastname: Newton
authors.forename: Simon
authors.initials: S
authors.lastname: Cousens
authors.forename: Seth
authors.initials: S
authors.lastname: Owusu-Agyei
authors.forename: Suzanne
authors.initials: S
authors.lastname: Filteau
authors.forename: Carolynne
authors.initials: C
authors.lastname: Stanley
authors.forename: Louise
authors.initials: L
authors.lastname: Linsell
authors.forename: Betty
authors.initials: B
authors.lastname: Kirkwood
mesh_terms: D000906:Antibodies / Q000097:blood; D019587:Dietary Supplements; D004311:Double-Blind Method; D004797:Enzyme-Linked Immunosorbent Assay; D005869:Ghana; D006801:Humans; D007109:Immunity; D007231:Infant, Newborn; D010919:Placebos; D023321:Poliovirus Vaccines / Q000276:immunology*; D013745:Tetanus Toxoid / Q000276:immunology*; D014801:Vitamin A / Q000008:administration & dosage*
chemical_list: D000906:Antibodies; D010919:Placebos; D023321:Poliovirus Vaccines; D013745:Tetanus Toxoid; D014801:Vitamin A