From the Research
Vitamin A supplementation is recommended for certain cases of measles in the United States, specifically for children aged 6 months to 2 years hospitalized with measles, children over 6 months with measles who have immunodeficiency, malnutrition, or vitamin A deficiency, and children with ophthalmologic evidence of vitamin A deficiency, with a recommended dosage of 200,000 IU for children over 12 months and 100,000 IU for those 6-12 months, given once daily for two days. While studies from developing countries have shown that vitamin A can reduce mortality and complications in children with measles, particularly those who are malnourished or vitamin A deficient, there are limited studies specifically examining its effectiveness in the U.S. population 1. The Centers for Disease Control and Prevention (CDC) recommends vitamin A for certain measles cases in the U.S. based on the understanding that vitamin A helps maintain epithelial tissue integrity and immune function, which can be compromised during measles infection.
Some key points to consider:
- A systematic review of randomized controlled trials comparing vitamin A with placebo found a 39% reduction in overall mortality when vitamin A was used for the treatment of measles, although this was not statistically significant 2.
- A study found that two doses of 200,000 IU of vitamin A were associated with a reduction in overall mortality and pneumonia-specific mortality in hospitalized children in areas with high case fatality 2.
- The World Health Organization (WHO) recommends administration of an oral dose of 200,000 IU (or 100,000 IU in infants) of vitamin A per day for two days to children with measles in areas where vitamin A deficiency may be present 3, 4, 1.
- In the U.S., severe vitamin A deficiency is rare, and routine vaccination has made measles uncommon, which explains the limited research specific to the U.S. population.
Overall, the evidence suggests that vitamin A supplementation can be beneficial in reducing mortality and complications in children with measles, particularly in areas with high case fatality and vitamin A deficiency. However, the effectiveness of vitamin A supplementation in the U.S. population is less clear due to the limited number of studies. The CDC's recommendation to use vitamin A supplementation in certain cases of measles in the U.S. is based on the available evidence and the potential benefits of vitamin A in reducing mortality and complications.