Community seroprevalence of SARS-CoV-2 in children and adolescents in England, 2019–2021

Abstract

ObjectiveTo understand community seroprevalence of SARS-CoV-2 in children and adolescents. This is vital to understanding the susceptibility of this cohort to COVID-19 and to inform public health policy for disease control such as immunisation.DesignWe conducted a community-based cross-sectional seroprevalence study in participants aged 0–18 years old recruiting from seven regions in England between October 2019 and June 2021 and collecting extensive demographic and symptom data. Serum samples were tested for antibodies against SARS-CoV-2 spike and nucleocapsid proteins using Roche assays processed at UK Health Security Agency laboratories. Prevalence estimates were calculated for six time periods and were standardised by age group, ethnicity and National Health Service region.ResultsPost-first wave (June–August 2020), the (anti-spike IgG) adjusted seroprevalence was 5.2%, varying from 0.9% (participants 10–14 years old) to 9.5% (participants 5–9 years old). By April–June 2021, this had increased to 19.9%, varying from 13.9% (participants 0–4 years old) to 32.7% (participants 15–18 years old). Minority ethnic groups had higher risk of SARS-CoV-2 seropositivity than white participants (OR 1.4, 95% CI 1.0 to 2.0), after adjusting for sex, age, region, time period, deprivation and urban/rural geography. In children <10 years, there were no symptoms or symptom clusters that reliably predicted seropositivity. Overall, 48% of seropositive participants with complete questionnaire data recalled no symptoms between February 2020 and their study visit.ConclusionsApproximately one-third of participants aged 15–18 years old had evidence of antibodies against SARS-CoV-2 prior to the introduction of widespread vaccination. These data demonstrate that ethnic background is independently associated with risk of SARS-CoV-2 infection in children.Trial registration numberNCT04061382.

National and regional prevalence of SARS-CoV-2 antibodies in primary and secondary school children in England: the School Infection Survey, a national open cohort study, November 2021SARS-CoV-2 antibody prevalence in school children

“…Antibody prevalence increased with age in primary and secondary school pupils. In primary school pupils, these data are in line with previous UK data reporting increasing seroprevalence with age, 16 and other regional and national seroprevalence studies reporting higher antibody prevalence in >10-year-olds than <10-year-olds. 17 , 18 Trends in secondary school students are harder to interpret because the characteristics of the vaccinated and unvaccinated are likely to be different.…”

Impact of maternal SARS-CoV-2 booster vaccination on blood and breastmilk antibodies

“…In these cases, absorption from milk was unlikely as IgG GMT was undetectable/low on paired maternal milk samples. However, it is possible that these infants experienced SARS-CoV-2 infection but did not seroconvert for anti-NP [ 42 , 43 ].…”

Serum HCoV-spike specific antibodies do not protect against subsequent SARS-CoV-2 infection in children and adolescents

“…‘STORY’ was a community-based cross-sectional seroprevalence study recruiting participants aged 0–24 years from 13 sites distributed across all seven NHS regions in England, conducted between October 2019 and June 2021. 9 The study recruited 2,963 participants 0–24 years, 2,477 of whom were aged 0–18 years. Of the total 2,477, 1,230 individuals (50%) identified as female and 426 (17%) identified as belonging to non-white ethnic groups.…”

“…To better understand immunological responses to SARS-CoV-2 and seasonal coronaviruses and the inter-relationship between the two, we analyzed data from two longitudinal cross-sectional seroprevalence studies ”COVID warriors” 8 ( ClinicalTrials.gov Identifier: NCT04347408 ) and ”STORY” 9 , 10 ( ClinicalTrials.gov Identifier: NCT04061382 ). Both studies were carried out within the UK between October 2019 and June 2021 when widespread immunization within the pediatric population was not available ( Figure 1 ) 11 .…”