Situation: During the twice-yearly Garantisadong Pambata week, a nurse at a Barangay Health Station (BHS) screens children under 5 years of age and counsels their mothers on nutrition. A 13-month-old boy received vitamin A 100,000 IU at 7 months of age and has had no dose since. He is well, and his mother keeps his record card. What should the nurse give today?

Infants 6 to 11 months receive vitamin A 100,000 IU once; children 12 to 59 months receive 200,000 IU every 6 months. The boy is now 13 months old and his last dose was 6 months ago, so he is due for 200,000 IU today. The dose is recorded to avoid duplication.

During the twice-yearly Garantisadong Pambata week, the nurse reviews the child’s age and previous vitamin A dose. The boy is now 13 months old, which places him in the 12 to 59 months age group. His last dose was 100,000 IU at 7 months of age, and he has had no dose since. Because supplementation is given every 6 months and the dose changes when the child reaches 12 months, he is due for the higher dose today.

The age-based schedule reflects the body’s increasing vitamin A requirement as the child grows. From 6 to 11 months, infants receive 100,000 IU once. From 12 to 59 months, the dose increases to 200,000 IU every 6 months. The larger dose is safe and appropriate for this age group because vitamin A stores are still being built, and periodic high-dose supplementation is a proven strategy to reduce deficiency and child mortality in areas where dietary intake is inadequate ^[4].

Key point! The dose is determined by the child’s current age, not by repeating the previous dose. Once a child turns 12 months, the standard dose becomes 200,000 IU.

Watch out! Do not give 50,000 IU to “avoid toxicity.” The 200,000 IU dose is a safe, high-potency supplement given at 6-month intervals, and the risk of deficiency far outweighs the risk of a single age-appropriate dose ^[4]. Toxicity is a concern with frequent, repeated high doses over a short period, not with the standard twice-yearly schedule.

The nurse should also record the dose on the child’s record card. This prevents duplication if the child is seen at another health station or during a subsequent outreach activity. In community-based programs, mothers’ awareness and correct use of the record card support timely follow-up and reduce missed or repeated doses .

Age group	Vitamin A dose	Frequency
6 to 11 months	100,000 IU	Once
12 to 59 months	200,000 IU	Every 6 months

Because the child is 13 months old and his last dose was 6 months ago, the correct action is to give 200,000 IU today. This aligns with the standard schedule and ensures the child maintains adequate vitamin A status during a critical period of growth and immune development ^[4].