News in brief: ATAGI prioritises children with lung disease for Pfizer vax; Home testing for OSA in kids is feasible; Health impact of bushfire smoke revealed

ATAGI recommends Pfizer vaccine for children with chronic lung conditions

Children aged 12–15 with lung disease such as cystic fibrosis and severe asthma  are among the high risk groups for COVID-19 that should prioritised for vaccination using the Comirnaty (Pfizer) vaccine, according to the Australian Technical Advisory Group on Immunisation (ATAGI)

Following the recent TGA approval of Pfizer vaccine to be extended from people aged 16 years and over to include children aged 12–15 years, ATAGI has recommended that children with specified medical conditions should be first to receive the vaccine, along with Aboriginal and Torres Strait Islander children and children living in remote communities.

Severe asthma is defined as requiring frequent hospital visits or the use of multiple medications, and the recommendation does not include mild or moderate asthma.

However in its advice, ATAGI acknowledges that myocarditis and/or pericarditis have recently been reported overseas in adolescents aged 12 and older following mRNA COVID-19 vaccines including Comirnaty.

It said the risk of these conditions appears higher in adolescents compared to adults, and that follow up is ongoing to understand the potential longer-term implications of myocarditis following COVID-19 vaccination.

Home testing for OSA in kids is feasible

Type 2 polysomnography (T2PSG) compares favourably with the gold standard type 1 in-laboratory polysomnography (T1PSG) for diagnosing obstructive sleep apnea (OSA) in children.

In an Australian study where 81 children aged 6-18 years old had simultaneous T2PSG and T1PSG in the lab, the investigators found an excellent correlation between the number of arousals, respiratory disturbance index and sleep stages with each test.

In a further group of 47 children aged 5-16 years comparing T2PSG performed at home with T1PSG in the sleep laboratory, there was a low false positive rate of 6.6% and false negative rate of 3% for those tests performed at home.

T2PSG at home demonstrated less stage 2 sleep, more REM sleep and higher sleep efficiency.

The study concluded that home T2PSG may be more representative of a ’normal’ night for children, could reduce waiting times for laboratory PSG, and possibly reduce costs of investigating and treating OSA.

Journal of Clinical Sleep Medicine

Health impact of bushfire smoke revealed

Smoke exposure during the 2019-20 bushfires has been significantly linked to adverse health effects among people with pre-existing respiratory conditions and those who were previously healthy.

A survey of more than 1,000 people found 60% of people with lung diseases such as asthma and COPD reported adverse health effects and 2% required hospitalisation

Adverse health effects were defined as taking medication to alleviate symptoms, visiting a health service due to symptoms or developing a chest infection within a week of the bushfire smoke exposure.

The study, led by Professor Raina MacIntyre from the Kirby Institute, found 15% of healthy people also reported adverse health impacts.

Younger adults were more likely to be affected than older people – presumably because they were more likely to go outside during smoky conditions.

American Journal of Respiratory and Critical Care Medicine

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