PURPOSE:
Subsets of children are targeted for influenza vaccination due to known conditions that increase the risk of influenza complications. The purpose of this study was to determine if severe obesity in children suggests targeted vaccination.
DESIGN AND METHODS:
A retrospective chart review of a large Midwestern pediatric hospital identified 188 cases of influenza complications (defined as requiring hospitalization or death) aged 2 to <20?years old from August 1, 2010 through June 30, 2013. Severe obesity was defined as body mass index (BMI) ≥99% for age and gender, with patients grouped by severe obesity status (yes vs. no). Cases were reviewed for previously identified risk conditions for influenza complications (e.g., asthma, pneumonia, diabetes), and were classified as having or not having a known high risk condition.
RESULTS:
Of 188 cases, 174 (93%) had a high-risk condition, while only 14 (7%) had no known condition. All 14 (100%) with no known high-risk condition had a BMI <99%. All 15 (100%) with BMI ≥99% had a known high-risk condition. The association between severe obesity status and influenza complications was not statistically significant (p?=?0.61).
CONCLUSIONS:
This suggests that severe obesity in children is not an independent high-risk condition for influenza complications defined as requiring hospitalization or resulting in death, once other known influenza risk factors are considered.
IMPLICATIONS:
Based on this data, clinicians should not target children for influenza vaccination based on weight status. We cannot comment about whether severe obesity represents increased risk for less severe cases of influenza.