Nutrition supplements alongside immunization increased measles vaccine coverage in Nigerian trial

Researchers in northern Nigeria evaluated whether distributing small-quantity lipid-based nutrient supplements (SQ-LNS) alongside routine immunization improved vaccine uptake. The open-label, pragmatic trial randomized 20 geographic clusters in two local government areas equally to the NutriVax strategy or standard immunization services. Intervention centers provided monthly SQ-LNS rations to children aged 6–23 months after routine immunization delivery. The primary endpoint was card-verified first-dose measles-containing vaccine (MCV1) coverage among children aged 12–23 months after 10 months of implementation.

The endline household survey, conducted 12 months after the baseline survey, included 1,604 children: 803 in intervention clusters and 801 in control clusters. In intervention clusters, 48% had ever received SQ-LNS. The odds of card-verified MCV1 receipt were higher with NutriVax (odds ratio 2.08; 95% CI 1.30–3.35; P=0.004). A cluster-conditional difference-in-differences analysis showed a 20.1-percentage-point increase in coverage relative to control (95% CI 13.7–26.5; P<0.0001).

The findings support integrating preventive nutrition services with routine vaccination in settings with high malnutrition burdens and low immunization coverage. However, the trial was open-label and involved only 20 clusters in two local government areas, limiting generalizability. The reported endpoint was documented vaccine uptake, not measles illness or mortality. No vaccine stockouts were reported during the study, a relevant consideration when applying the strategy elsewhere.