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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Landscape analysis of interactions between nutrition and vaccine responses in children
Journal of Nutrition, Volume 139, No. 11, Year 2009
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Description
The world's poorest children are likely to be malnourished when receiving their childhood vaccines. It is uncertain whether this affects vaccine efficacy and whether the coadministration of nutrient supplements with vaccines has beneficial or detrimental effects. More recently, a detrimental interaction between vitamin A (VA) supplementation (VAS) and the killed diphtheria-tetanus- pertussis vaccine given in early childhood has been suggested. This report provides a critical review of the published interactions between nutritional status and/or supplementation and vaccine responses in children. Due to an absence of evidence for most nutrients, this analysis focused on protein-energy, vitamins A and D, and iron and zinc. All vaccines were considered. Both observational studies and clinical trials that led to peer-reviewed publications in English or French were included. These criteria led to a pool of 58 studies for protein-energy malnutrition, 43 for VA, 4 for vitamin D, 10 for iron, and 22 for zinc. Our analysis indicates that malnutrition has surprisingly little or no effect on vaccine responses. Evidence for definitive adjunctive effects of micronutrient supplementation at the time of vaccination is also weak. Overall, the paucity, poor quality, and heterogeneity of data make it difficult to draw firm conclusions. The use of simple endpoints that may not correlate strongly with disease protection adds uncertainty. A detailed examination of the immunological mechanisms involved in potential interactions, employing modern methodologies, is therefore required. This would also help us understand the proposed, but still unproven, negative interactions between VAS and vaccine safety, a resolution of which is urgently required. © 2009 American Society for Nutrition.
Authors & Co-Authors
Savy, Mathilde
Unknown Affiliation
Edmond, Karen Margaret
Unknown Affiliation
Fine, Paul E.M.
Unknown Affiliation
Hall, Andrew J.
Unknown Affiliation
Hennig, Branwen J.W.
Unknown Affiliation
Moore, Sophie E.
Unknown Affiliation
Mulholland, Edward Kim
Unknown Affiliation
Schaible, Ulrich Emil
Unknown Affiliation
Prentice, Andrew M.
Unknown Affiliation
Statistics
Citations: 134
Authors: 9
Affiliations: 4
Identifiers
Doi:
10.3945/jn.109.105312
ISSN:
00223166
Research Areas
Food Security
Genetics And Genomics
Maternal And Child Health