Evidence for children with poorly controlled asthma to be prioritised for COVID-19 vaccine

A Scottish study has found that children with poorly controlled asthma are three to six times more likely to be hospitalised with COVID-19 than those without the condition.

The findings have led the authors to recommend that children aged 5 and over with the condition should be considered a priority for COVID-19 vaccination and that affected children over 12 years’ old, who are already currently eligible, should strongly consider getting vaccinated as soon as possible.

The analysis from researchers at Public Health Scotland and Universities of Edinburgh, Aberdeen, Glasgow, Strathclyde and St Andrews was carried out to identify which children with asthma were at increased risk of experiencing severe outcomes due to COVID-19.

Working with the EAVE-II project team (external website), who use anonymised linked patient data across Scotland, the authors were able to identify 63,463 children diagnosed with asthma. They then focussed on poorly controlled asthma, defined as prior hospitalisation for asthma or being prescribed at least two courses of oral steroids in the previous two years.

The study found 255 per 100,000 of children with poorly controlled asthma were hospitalised with COVID-19 compared to 91 per 100,000 of children with well controlled asthma and 54 per 100,000 of children without asthma.

Among children with asthma, 548 per 100,000 of children who had been in hospital for asthma in the previous two years were hospitalised with COVID-19 compared with 94 per 100,000 who were not hospitalised for asthma in the previous two years.

The results have led to the author’s recommendation that some 9,000 children with poorly controlled asthma in Scotland could benefit from being vaccinated – and more than 109,000 children could benefit across the UK. 

Professor Chris Robertson of Public Health Scotland and University of Strathclyde, who co-authored the study, said:

“COVID-19 can be a severe disease among children and this study has provided additional insight into which conditions can put some young individuals more at-risk. We hope the findings can assist the JCVI with its efforts to identify those who should be eligible for the vaccine and further extend the offer of protection to those most vulnerable to the virus.

“COVID-19 vaccines are already available for children over 12 years old and I would encourage those who have not yet been vaccinated to strongly consider this option, particularly those who have experienced issues with asthma”.

The 'Risk of COVID-19 hospital admission among children aged 5–17 years with asthma in Scotland: a national incident cohort study' (external website) can be accessed on The Lancet Respiratory Medicine Journal website.