Indian Academy of Pediatrics

There is a proposal to link massive dose Vitamin A prophylaxis with pulse polio immunization in under-five children. The members of the IAP Subspecialty Chapter on Nutrition carefully deliberated the merits and demerits of this proposal. It was opined that:

1. There is unambiguous evidence of appreciable secular decline in clinical Vitamin A deficiency in under-five children in the country.
2. Recent data indicates that Vitamin A supplementation in infancy does not have any beneficial effect on growth, morbidity and mortality.
3. It was felt that linking Vitamin A to the pulse polio program is inappropriate; the routine program should not be destabilized except under exceptional circumstances. Concerns were expressed regarding the difficulties in keeping adequate records of Vitamin A dosing, the distinct possibility of toxicity or side effects due to multiple dosing within 6 months and the negative impact on Vitamin A administration through the routine services as at present. The changed strategy would mean that all nutrition and health workers would have to be instructed to discontinue routine Vitamin A administration and established systems for distribution of Vitamin A supplies would become immobilized. When pulse polio program ceases to exist, reinitiation of routine Vitamin A administration would have obvious implications in terms of retraining, logistics and supplies.