(i) There is no compelling epidemiological data to indicate an increase in clinical vitamin A deficiency specifically in children above three years of age. Thus, scientific evidence does not support the need for mega-dose supplementation in this age group.

(ii) The recent recommendations from the above groups/committees for selecting the eligible children for vitamin A supplementation were unanimously endorsed. These recommendations state: (a) Under the vitamin A supplementation program, children between 9 months to 36 months of age are to be provided Vitamin A solution every six months starting with 100,000 IU at 9 months age with measles vaccination, and subsequently 200,000 IU every six months till 36 months of age; (b) Children with a clinical diagnosis of severe protein energy malnutrition (visible severe wasting or edema both feet) should be given an additional dose of 100,000 IU vitamin A solution at the time of diagnosis, if the child has not received a mega dose of vitamin A in the preceding four weeks; (c) In severely malnourished children (weight for age below -3 SD) above 3 years of age, a single dose of vitamin A (200,000 IU) is to be given at the time of diagnosis by a physician, if the child has not received a mega dose of vitamin A in the preceding four weeks; (d) Children with measles should be given an additional dose of vitamin A at the time of contact as per their age and nutritional status, if the child has not received a mega dose of vitamin A in the preceding four weeks as outlined above (100,000 IU below 12 months age or in severely malnourished children below 36 months of age, and 200,000 IU for others).

(iii) The State Branches of the Indian Academy of Pediatrics should be requested to reinforce to their respective nodal State Ministries to restrict the vitamin A supplementation program to only the eligible children as defined above.