3.3.5  Vitamin A supplements and measles prevention

It is important to know that in countries such as Ethiopia where vitamin A deficiency frequently occurs among children, vitamin A should be given routinely every six months. If a child has not previously received a vitamin A supplement, it should be given at the same time as the measles vaccine. This is because measles increases the risk of blindness due to vitamin A deficiency. Signs of vitamin A deficiency are white spots on the sclera (white part of the eye) and clouding of the cornea (the thin tissue covering the black centre of the eye and the coloured parts around it). In severe cases, blindness results.

Do not put the vitamin A capsule into the child’s mouth, or allow the child to swallow the capsule.

Vitamin A is supplied in capsules of 100,000 IU (international units, which is the standard measurement for vitamin doses). Each capsule has a nipple at one end. The drops are given by cutting across the middle of the nipple with scissors and immediately squeezing the drops into the child’s mouth (Figure 3.3 on the next page). Vitamin A drops are also given in Child Health Days to ensure the dose is repeated every six months, until the child reaches five years.

Figure 3.3  A child receiving vitamin A drops at a scheduled immunization clinic where he will also receive measles vaccine. (Photo: UNICEF Ethiopia/Indrias Getachew)

The routine dose of vitamin A for a child aged 6–11 months is the drops from one capsule (100,000 IU); the drops from two capsules (200,000 IU) are given to children aged 12–59 months at regular intervals, every six months. This ensures that all children are fully protected from the harmful effects of vitamin A deficiency.

Vitamin A for children with measles

What should you do if you see a child who has already developed measles? Do not give vitamin A drops if the child has received a dose within the last month. But if a child with measles has not recently received a vitamin A supplement, give the vitamin A treatment dosages summarised in Table 3.4. The second dose should be given 24 hours after the first dose.

Table 3.4  Vitamin A treatment dosages for children with measles in different age-groups.
AgeImmediately on diagnosisAfter 24 hoursFollow-up
Infants less than 6 months old50,000 IU50,000 IUThird dose given two to four weeks later if there are still signs of vitamin A deficiency
Infants aged 6–11 months100,000 IU100,000 IU
Children aged 12 months and over200,000 IU200,000 IU

3.3.4  Contraindications for measles vaccine, adverse events and how to manage them

3.4  Rotavirus vaccine