Emergence of SARS-CoV-2 variants of concern in the pediatric population of the United States

Abstract

The evolution of SARS-CoV2 virus has led to the emergence of variants of concern (VOC). Children, particularly <12 years old not yet eligible for vaccines, continue to be important reservoirs of SARS-CoV-2 yet VOC prevalence data in this population is lacking. We report data from a genomic surveillance program that includes 9 U.S. children's hospitals. Analysis of SARS-CoV-2 genome from 2119 patients <19 years old between 03/20 to 04/21 identified 252 VOCs and 560 VOC signature mutations, most from 10/20 onwards. From 02/21 to 04/21, B.1.1.7 prevalence increased from 3.85% to 72.22% corresponding with the decline of B.1.429/B.1.427 from 51.82% to 16.67% at one institution. 71.74% of the VOC signature mutations detected were in children <12 years old, including 33 cases of B.1.1.7 and 119 of B.1.429/B.1.427. There continues to be a need for ongoing genomic surveillance, particularly among young children who will be the last groups to be vaccinated.

Dynamic of SARS-CoV-2 variants circulation in Tunisian pediatric population, during successive waves, from March 2020 to September 2022

“…Children can potentially transmit the virus through close contacts with other children and adults, especially in crowded areas such as scholar structures and districts with poor social economic conditions ( Laxminarayan et al, 2020 ; Kelly, 2020 ). Therefore, adequate measures, such as vaccination, should be adapted to prevent infection among children and also to limit their role in the virus spread ( Maldonado-Cabrera et al, 2023 ; Bard et al, 2021 ).…”

Would New SARS-CoV-2 Variants Change the War against COVID-19?

“…Concerns about not acquiring post-vaccination herd immunity also include the uneven distribution of vaccines among countries and within individual countries, and the age limit of vaccination (although vaccination is now recommended for everyone ages 5 years and older by the CDC (U.S. Centers for Disease Control and Prevention)). These factors make it more difficult to reach the levels of the vaccinated population needed to achieve herd immunity [33] [34].…”

“…For example, the CDC reported that Massachusetts (USA) has already fully vaccinated more than 4 million people (out of 7.03 million total) (56.899%). The total rate of fully vaccinated people in the Barnstable County is 76% [31], with the vaccination levels by age category being as follows: 86% (75+), 77% (50-64), 80% (30)(31)(32)(33)(34)(35)(36)(37)(38)(39)(40)(41)(42)(43)(44)(45)(46)(47)(48)(49), 62% (20-29), 64% (16)(17)(18)(19), and 43% (12-15) (https://www.wcvb.com/article/massachusetts-covid-breakthrough-cases-deltavariant-pandemic-vaccine-data-charts-maps/37089843 (accessed on 10 December 2021)). However, the Department of Public Health of Massachusetts reported 7737 total COVID-19 breakthrough cases in fully vaccinated individuals as of 3 August 2021.…”

Would New SARS-CoV-2 Variants Change the War Against COVID-19?

“…These factors make it more difficult to reach the levels of the vaccinated population needed to achieve herd immunity [32]. A preprint study reported sequencing of over 2,000 samples from COVID-19 patients below the age of 19 years and found more than 250 VOCs, with over 70% of the VOCs in children below the age of 12, including 33 cases of B.1.1.7 (Alpha) and 119 of B.1.429/B.1.427 (Kappa) variants [33].…”