Is your child too fat? (Indicated Image/Pexels)
Parents all over the world are worried that children should be vaccinated against COVID-19. Vaccination has started in Australia for children 12 years of age or older and vaccination of children aged 5 to 11 years is also being seriously considered. Vaccination of children is about to start in some other countries as well.
In such a situation, many parents must be thinking about the advantages and disadvantages of vaccination of their children. Experts say that being overweight is an important factor in children, which increases the risk of COVID infection progressing to serious disease in other people, including children. Despite this, the benefits of vaccination for overweight or obese children have not received much attention.
What does the evidence say about this?
Experts Philip Britton, Lewis Baur and Nicholas Wood at the University of Sydney, Australia have written about this in detail. According to this research report published in The Conversation, several studies have shown that children and young people who are overweight and obese are more likely to go to the hospital or become seriously ill from COVID-19.
Defining overweight and obesity in a child is based on their BMI i.e. the ratio of weight to height (Body Mass Index). Like most aspects of health in children, they are likely to change as they grow and develop.
Obesity and diabetes are a big risk
A large study of over 43,000 hospitalized children under the age of 18 in the US highlighted the main conditions that made a child more likely to be hospitalized with COVID, namely diabetes. and obesity. If hospitalized with COVID, having diabetes, obesity or heart disease increases the risk of serious illness that requires intensive care.
A recent study of more than 400 COVID patients in children from Canada, Iran and Costa Rica showed that obesity was associated with severe COVID-19, especially in those over the age of 12. Obesity was the only major health condition that tripled the risk of severe COVID-19 in this age group. In Australia, two-thirds of children who require ICU-level care for COVID are overweight.
Why is obesity such a big factor?
It’s not exactly clear, but it appears that being overweight and obese specifically affects how well our immune system can control the virus early in infection.
Obesity is a major risk factor for severe COVID-19 even in adults. This so-called metabolic syndrome often accompanies diabetes, hypertension and other diseases. All these diseases are associated with more severe COVID and similarly poorly regulated immune responses.
Obesity can also have a mechanical effect, in which obesity limits the movement of the chest wall leading to reduced lung activity and airway size during times of stress. Obesity is also a major risk factor for severe influenza, potentially due to some of the same mechanisms.
…then what can be done?
Parents should be aware that their child’s weight can affect the risk of severe covid. Parents should also include the weight of themselves and their children in their family’s decisions regarding COVID prevention, including vaccination. Vaccines provide the best protection against COVID if you or they are overweight. If you think your child may be overweight, talk to your GP and consider making some changes to the family’s physical activity, screen time, sleeping and eating behaviour.
Obesity also needs to be included in national decision-making around vaccination priorities. When vaccines were first made available to children aged 12-15 years, several health conditions were listed as ‘severe conditions associated with an increased risk of COVID-19’. There was mention of severe obesity, but it was not ranked in the list, so little attention was paid to weight.
Preference should be given to obese people
Of all the recommended groups to be vaccinated, people with obesity should be given top priority, as it is one of the highest risk factors for severe COVID-19. Parents should be aware of the weight of themselves and their children as an important issue in making a decision about vaccination.
Health practitioners and policy makers should prioritize excess weight and obesity as health conditions in current and future vaccine programs. It can be uncomfortable to talk about, but weight is an important factor that makes covid worse in children too. We need to talk about this so that parents can make an appropriate decision about the risks and benefits of vaccination for their child.
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