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Does India Need a Universal High-Dose Vitamin A Supplementation Program?

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Abstract

High dose vitamin A (HDVA) concentrate began to be distributed in India in 1970 as a short-term, stop-gap approach to reduce clinical signs of vitamin A deficiency. As this problem declined globally, the purpose of distributing them changed to the reduction of young child mortality. However, their impact on this has also declined, if not disappeared, as suggested in India by the enormous DEVTA study. This may be because of improved protection against and treatment of the main morbidity involved, measles and diarrhea. At the same time, semi-annual provision of mega-doses of vitamin A is not without risks, in particular linked to children’s vaccination status. While a single dose is inexpensive, large-scale implementation of HDVA programs is expensive, particularly the opportunity cost involved in reducing the time health workers involved have to deal with their other commitments. Balancing potential benefits, risks and costs leads us to recommend an immediate cessation of the distribution of HDVA in India.

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Authors and Affiliations

  1. Formerly, Department of Food and Nutrition, Hanyang University, Seoul, South Korea

    Ted Greiner

  2. Formerly, Department of Global Community Health and Behavioral Sciences, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, USA

    John Mason

  3. Research Centre for Vitamins and Vaccines, Bandim Health Project, Statens Serum Institute, Copenhagen, Denmark and OPEN, Institute of Clinical Research, University of Southern Denmark, Odense, Denmark

    Christine Stabell Benn

  4. Department of Pediatrics and Clinical Epidemiology, Sitaram Bhartia Institute of Science and Research, Qutab Institutional Area, New Delhi, India

    H. P. S. Sachdev

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  1. Ted Greiner
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  2. John Mason
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  3. Christine Stabell Benn
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  4. H. P. S. Sachdev
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All the four authors contributed to the writing of this article and each has read and agreed to the wording in the final, submitted version.

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Correspondence to Ted Greiner.

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Greiner, T., Mason, J., Benn, C.S. et al. Does India Need a Universal High-Dose Vitamin A Supplementation Program?. Indian J Pediatr 86, 538–541 (2019). https://doi.org/10.1007/s12098-018-02851-x

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  • DOI: https://doi.org/10.1007/s12098-018-02851-x

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