Severe Obesity in Children May Not Pose Independent Risk for Influenza Complications

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 reviewof a largeMidwestern pediatric hospital identified 188 cases of influenza complications (defined as requiring hospitalization or death) aged 2 to b20 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 highrisk 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. (c) 2018 Elsevier Inc. All rights reserved.