Adequate immune response to tetanus toxoid and failure of vitamin A and E supplementation to enhance antibody response in healthy children

The effects of vitamin A and vitamin E supplementation on the IgG response to tetanus toroid after primary immunization were evaluated in a prospectiv e, randomized controlled clinical trial involving 89 healthy infants with n ormal serum vitamin A and E levels at 2 months of age. Before the first dos e of DPT vaccine, the infants were randomly enrolled into four different st udy groups [Group I (n = 24): 30,000 IU vitamin A for 3 days just after eac h three doses of primary vaccination, Group II (n = 21): 150 mg oral vitami n E for only 1 day after the injections for primary immunization, Group III (n = 21): vitamins A and E together in the same order, Group IV (n = 23) n o vitamin after DPT vaccines]. Serum tetanus antitoxin (IgG) titres were me asured three times; initially at 2 months of age before the first dose of D PT, secondly at 5 months of age 1 month after primary immunization and thir dly at 16-18 months of age before the booster dose of DPT. Before the first dose of the DPT vaccine, 1 month after the third DPT injection and at 16-1 8 months before the booster dose of DPT, there was no significant differenc e in serum tetanus antitoxin levels between these four groups. A significan t increase was observed in all the groups when serum tetanus antitoxin leve ls before (2 months) and after (5 months) primary immunization were compare d. In addition, serum antibody levels against tetanus significantly decreas ed in the four groups before booster vaccination. Before the beginning of p rimary immunization, 15 infants (16.8%) had serum tetanus antitoxins (IgG) below protective level. After three doses of DPT, all the infants had prote ctive antitoxin levels. At 16-18 months of age before booster dose, four in fants (10%) also had serum tetanus antitoxins (IgG) below the protective le vel. No side-effects were observed except bulging fontanelle in two infants in Group I. (C) 2000 Elsevier Science Ltd. All rights reserved.