Understanding the Schedule for Vitamin A Prophylaxis

December 11, 2025 •

3 min read

According to the World Health Organization (WHO), over 190 million preschool-age children in Africa and Southeast Asia are affected by vitamin A deficiency. The schedule for vitamin A prophylaxis is a key intervention to combat this deficiency, reducing preventable blindness and child mortality in at-risk populations.

Quick Summary

The prophylactic vitamin A schedule involves supplementation for children aged 6 to 59 months in areas with high deficiency prevalence. Supplementation is administered periodically, with specific amounts tailored to different age groups. This intervention significantly reduces child mortality and illness.

Key Points

Age-Specific Amounts: For prophylaxis, infants aged 6–11 months receive a specific amount, while children aged 12–59 months receive another amount, as recommended by health authorities.
Regular Frequency: Amounts are typically administered every 4–6 months to maintain adequate vitamin A stores.
Target Population: Prophylaxis is for children in populations where vitamin A deficiency (VAD) is a public health problem.
Administration Method: The supplement is given orally, usually as drops from a gelatin capsule.
Benefits: Regular supplementation has been shown to reduce child mortality, blindness, and susceptibility to infections like measles and diarrhea.
Distinction from Treatment: Prophylactic schedules differ from the more intensive, short-term therapeutic schedules used for children with clinical signs of VAD.

Introduction to vitamin A prophylaxis

Vitamin A prophylaxis is a low-cost, high-impact public health intervention designed to combat vitamin A deficiency (VAD) in regions where it is a public health problem. VAD can lead to severe health issues, including visual impairment, blindness, weakened immune systems, and increased susceptibility to infectious diseases like measles and diarrhea. The World Health Organization (WHO) and other international bodies recommend routine supplementation to vulnerable populations, particularly infants and young children, to build and maintain the body's vitamin A stores.

Unlike daily or weekly supplements, this prophylaxis involves giving large, infrequent amounts. The body, primarily the liver, can store vitamin A and release it over several months, making this schedule effective for preventing deficiency. Integrating supplementation into existing health services, such as immunization campaigns, is a common and successful strategy to ensure high coverage.

The WHO-recommended schedule for children

For children aged 6–59 months living in areas with a public health problem of vitamin A deficiency, the WHO provides a standardized schedule. The amounts administered are based on age to maximize impact while ensuring safety. Supplementation is given orally as an oil-based preparation.

Infants aged 6–11 months: Receive a single amount specific for this age group. This should be given once, with subsequent doses beginning at 12 months.
Children aged 12–59 months: Receive an amount specific for this age group periodically. These periodic administrations continue until the child reaches five years of age.

This schedule is crucial for boosting immunity and preventing long-term damage caused by VAD. In many countries, the first dose is given alongside the measles vaccine at nine months of age to streamline delivery.

Special considerations and national variations

While the WHO provides the international standard, some countries may adapt the schedule to fit local needs, such as combining it with other health interventions or conducting special campaigns. For instance, India’s national program provides a series of administrations for children between 9 months and 5 years.

Newborns (under 6 months): Routine high-amount supplementation for newborns is not universally recommended, with exclusive breastfeeding for the first six months being the primary recommendation. However, some groups like the International Vitamin A Consultative Group (IVACG) have endorsed smaller amounts in high-risk areas, sometimes linked with infant vaccines. Postpartum mothers in at-risk regions may also receive supplementation to enrich breast milk.
Children with specific conditions: Children suffering from measles, severe malnutrition, or xerophthalmia (clinical vitamin A deficiency) require a different therapeutic schedule rather than the standard prophylactic one. These treatment protocols involve repeated administrations over a shorter period.

The administration process

For prophylactic supplementation, vitamin A is typically administered orally using gelatin capsules that contain an oil-based preparation. Health workers or caregivers can safely cut the capsule's nipple and squeeze the contents into the child's mouth. The child should swallow the liquid, and health workers must ensure the capsule's contents are not spit out. It is important to note that vitamin A supplements in capsules should never be given by injection. For safety, there is a recommended minimum interval between administrations. This is different from therapeutic schedules for existing deficiencies, which require closer monitoring.

Comparison of prophylactic and therapeutic schedules


Feature	Prophylactic Schedule (Prevention)	Therapeutic Schedule (Treatment)
Target Population	All children 6–59 months in at-risk areas.	Children with clinical VAD (e.g., xerophthalmia, night blindness) or severe illness (e.g., measles, severe malnutrition).
Amount	Age-specific amounts recommended by health organizations.	Age-specific amounts typically higher or more frequent than prophylactic.
Frequency	Periodically, often every few months, until age 5.	More frequent, specific schedule depending on the condition.
Context	Mass health campaigns, routine health visits (e.g., immunization).	Immediate medical emergency or clinical treatment setting.
Purpose	To build and maintain the body's vitamin A stores to prevent deficiency.	To rapidly reverse the effects of severe, existing vitamin A deficiency.

Conclusion

Vitamin A prophylaxis follows a well-defined schedule critical for preventing vitamin A deficiency and its severe health consequences in young children living in vulnerable populations. The standard schedule, recommended by the WHO, involves administering high-amount oral supplements periodically to children between 6 and 59 months of age. Specific amounts are recommended for infants aged 6–11 months and children aged 12–59 months. While this is a standard international approach, some national programs may have slight variations to best suit their specific needs. Understanding this schedule is vital for parents and health workers in ensuring this low-cost intervention can continue to improve child survival rates and health outcomes globally.

Visit the WHO's website for more official information on vitamin A supplementation.

Frequently Asked Questions

For prophylactic purposes in areas with vitamin A deficiency, a 1-year-old child should receive an amount specific for this age group periodically, following the guidance of health professionals or programs.

A child in an at-risk region should receive a high-amount vitamin A supplement periodically, often every 4 to 6 months, until they reach five years of age, as per health guidelines.

Yes, administering vitamin A supplements with routine immunizations, such as the measles vaccine, is a safe and common practice.

Yes, high-amount vitamin A is generally considered safe for infants when administered according to recommended age-specific amounts. Any mild, transient side effects like irritability or vomiting are uncommon and resolve quickly.

Routine high-amount supplementation is not recommended for newborns under six months; exclusive breastfeeding is the primary method to ensure adequate vitamin A intake during this period. Some protocols for high-risk areas may include lower amounts.

Health programs often advise using any opportunity, such as a routine health visit, to provide the supplement if a child has not received it recently, following established guidelines.

No, a child with measles or other clinical signs of vitamin A deficiency requires a different, therapeutic treatment schedule involving repeated administrations over a shorter period.