Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2024 Dec 28:17:6161-6175.
doi: 10.2147/JMDH.S504464. eCollection 2024.

A New Conceptual Framework for Enhancing Vaccine Efficacy in Malnourished Children

Guillaume N Mwamba  1   2 , Michel Kabamba Nzaji  1   2 , Oscar Luboya Numbi  3 , Mala Ali Mapatano #  4 , Paul-Samson Lusamba Dikassa #  5
Affiliations
Review

A New Conceptual Framework for Enhancing Vaccine Efficacy in Malnourished Children

Guillaume N Mwamba et al. J Multidiscip Healthc. .

Abstract

Background: Malnourished children in low- and middle-income countries (LMICs) often exhibit reduced vaccine efficacy, particularly for oral vaccines like polio and rotavirus, due to impaired immune responses. Nutritional deficiencies, such as in vitamin A and zinc, along with environmental factors like poor sanitation, exacerbate this issue. Existing research has explored the individual impacts of malnutrition on vaccine outcomes, but a comprehensive framework that integrates nutritional, immune, and environmental factors has been lacking.

Objective: This article proposes a new conceptual framework that integrates nutritional status, immune function, and environmental context to explain the reduced vaccine efficacy in malnourished populations. The study highlights practical interventions to improve vaccine outcomes in these vulnerable populations.

Methods: A comprehensive literature review was conducted, focusing on vaccine efficacy in malnourished children, with data drawn from cross-sectional surveys, program evaluations, and peer-reviewed studies. Key interventions, including vitamin A supplementation, flexible immunization schedules, and environmental health programs, were analyzed for their impact on improving seroconversion rates.

Results: The review confirms that malnourished children exhibit significantly lower seroconversion rates for vaccines like oral polio and rotavirus, with a 30-40% reduction in efficacy for OPV and up to a 50% reduction for rotavirus. Nutritional interventions, particularly vitamin A supplementation, increased seroconversion rates by up to 30%, while flexible vaccination schedules and environmental improvements further enhanced vaccine responses in severely malnourished populations.

Conclusion: This framework addresses a critical gap in the literature by offering a holistic approach that integrates nutrition, immunization, and environmental health. Global health organizations, such as WHO and UNICEF, must prioritize the integration of nutrition and immunization programs, alongside environmental health initiatives, to reduce the burden of vaccine-preventable diseases in malnourished populations. Future research should focus on longitudinal studies to assess the long-term impact of these integrated interventions.

Keywords: LMICs; OPV; environmental health; immunization programs; low- and middle-income countries; malnutrition; mucosal immunity; nutritional supplementation; oral polio vaccine; rotavirus vaccine; seroconversion rates; vaccine efficacy; vitamin A.

PubMed Disclaimer

Conflict of interest statement

The authors declare that they have no conflicts of interest.

Figures

Figure 1
Figure 1
Seroconversion Rates for OPV in Malnourished vs Well-Nourished Children.
Figure 2
Figure 2
Correlation between malnutrition and measles vaccine efficacy.
Figure 3
Figure 3
Seroconversion Rates for Rotavirus Vaccine.
Figure 4
Figure 4
Impact of Poor Environmental Conditions on Vaccine Efficacy.
Figure 5
Figure 5
Feedback Loop of Malnutrition, Immune Suppression; and Infection.
Figure 6
Figure 6
Seroconversion Rates with and without Nutritional Supplementation.
Figure 7
Figure 7
Simplified version of the conceptual framework showing the interaction between nutritional status, immune function, and environmental context in influencing vaccine efficacy in malnourished children.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Besnier E, Thomson K, Stonkute D. et al. Which public health interventions are effective in reducing morbidity, mortality and health inequalities from infectious diseases amongst children in low- And middle-income countries (LMICs): an umbrella review. PLoS One. 2021;16(6):e0251905. doi:10.1371/journal.pone.0251905 - DOI - PMC - PubMed
    1. Organization, W. H. Immunization coverage. Fact Sheet N 2024;378 1.
    1. Black RE, Victora CG, Walker SP, et al. Maternal and child undernutrition and overweight in low-income and middle-income countries. Lancet. 2013;382:427–451. - PubMed
    1. Bhutta ZA. Evidence-based interventions for improvement of maternal and child nutrition: what can be done and at what cost? Lancet. 2013;382:452–477. - PubMed
    1. Dadari I, Belt RV, Iyengar A, et al. Achieving the IA2030 Coverage and Equity Goals through a Renewed Focus on Urban Immunization. Vaccines. 2023;11:1–16. - PMC - PubMed

LinkOut - more resources