Reduced seroconversion to measles in infants given vitamin A with measles vaccination
Semba, R.D.; Munasir, Z.; Beeler, J.; Akib, A.; Muhilal; Audet, S.; Sommer, A.
Lancet 345(8961): 1330-1332
1995
ISSN/ISBN: 0140-6736 PMID: 7752754 DOI: 10.1016/s0140-6736(95)92536-8Document Number: 248956
In 19 villages in the Bogor District of West Java, Indonesia, between December 1992 and March 1993, pediatricians immunized 336 infants 6 months old with 0.5 ml of the standard-titer Schwarz measles vaccine and administered either 100,000 IU vitamin A (169 infants) or a placebo (167 infants) at the same time. The researchers wanted to determine the effect of vitamin A administration on antibody responses to the measles vaccination. 82% of 306 infants seroconverted to measles. About 33% of the 336 infants had no detectable maternal antibodies to measles, indicating that they were very vulnerable to measles infection. The multiple logistic regression model controlling for maternal antibody titers found that vitamin A administration reduced the likelihood of seroconversion to measles (odds ratio [OR] = 0.4). Females were less likely to seroconvert than males (OR = 0.34). At 1 and 6 months after immunization, infants who were administered vitamin A had a 25% lower geometric mean than those who were administered the placebo (p = 0.05 and 0.09, respectively). They were also less likely than the placebo group to develop a generalized rash (8.7% vs. 15.9%; p 0.05), suggesting that vitamin A may limit replication of vaccine-strain measles vaccine. These results suggest that simultaneous high- dose vitamin A may thwart seroconversion to live measles vaccine in infants with maternal antibodies. More research is needed.