Children with poorly controlled asthma need Covid vaccine on priority, study in Lancet says

The study says children aged 5–17 years with poorly controlled asthma are at higher risk of Covid-19 hospital admission compared with those without asthma.

Representational image of children with healthcare workers at a Covid care centre | Photo: ANI

New Delhi: Even as the government of India is clear that it is in no hurry to start vaccinations among children, a Scottish study involving over 7,50,000 schoolchildren aged between 5-17 years has concluded that children with poorly controlled asthma need to be prioritised for vaccinations. The study, conducted between March 2020 and July 2021, has been published in The Lancet Respiratory Medicine.

The study by researchers from the Universities of Edinburgh, Glasgow and Strathclyde, concluded: “School-aged children with asthma with previous recent hospital admission or two or more courses of oral corticosteroids (markers for asthma being ‘poorly controlled’) are at markedly increased risk of Covid-19 hospital admission and should be considered a priority for vaccinations. This would translate into 9,124 children across Scotland and an estimated 1,09,448 children across the UK”. 

“Understanding which children with asthma are at increased risk of serious Covid-19 outcomes is critical to ongoing policy deliberations on vaccine prioritisation. Our analysis provides the first national evidence of the risk of Covid-19 hospitalisations among school-aged children with markers of poorly controlled asthma,” lead author Professor Aziz Sheikh from the University of Edinburgh said in a statement.

The findings are also important in the Indian context, because the high levels of pollution in North India, particularly Delhi, can worsen asthma symptoms. Furthermore, around six per cent of Indian children are estimated to be asthmatic.

India so far has one vaccine that is licensed for use in children aged between 12-18 years, but there is no policy yet on the vaccination of children. 

Health minister Mansukh Mandaviya has said on multiple occasions that the government would like to consider all aspects carefully before taking a call on the matter. However, some statements have been made, including by Dr N.K. Arora, chairman of the Covid working group of the National Technical Advisory Group on Immunisation (NTAGI), that children with comorbidities are likely to be prioritised.

Asthmatic children at much greater risk 

The study found that children with poorly controlled asthma are more likely to be hospitalised with Covid compared to their healthy counterparts. “We found that children aged 5–17 years with poorly controlled asthma are at markedly increased (3–6 times higher) risk of Covid-19 hospital admission compared with those without asthma,” the authors wrote in the study.

Highlighting this point, Sheikh said: “The key takeaway from this study is that keeping children’s asthma under control is critical as this greatly reduces the risk of Covid-19 hospitalisation. Vaccinating those with poorly controlled asthma offers an additional important layer of protection from serious Covid-19 outcomes.”

Asthma affects an estimated 78 million children the world over. The Global Asthma Report 2018 estimated that 6 per cent of Indian children have asthma. Some estimates suggest that the total number of asthma patients in India could be in the range of 1.5-2 crore. 

The World Health Organization defines asthma as a long-term condition in which air passages in the lungs become narrow due to inflammation and there is tightening of the muscles around the small airways. This causes the common symptoms of asthma: cough, wheeze, shortness of breath and tightness in the chest. These symptoms are intermittent and are often worse at night or during exercise.

(Edited by Saikat Niyogi)