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

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

Objective: To 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. Design: We 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. Results: Post-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. Conclusions: Approximately 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 number: NCT04061382.

COVID-19, epidemiology, healthcare disparities, paediatrics
0003-9888
Ratcliffe, Helen
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Tiley, K.S.
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Andrews, Nick
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Amirthalingam, Gayatri
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Vichos, I.
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Morey, E.
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Douglas, N.L.
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Marinou, S.
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Plested, Emma
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Aley, Parvinder
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Galiza, Eva P.
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Faust, Saul N.
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Hughes, S.
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Murray, Clare S.
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Roderick, Marion
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Shackley, Fiona
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Lees, Tim
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Raman, M.
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Owens, Stephen
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Turner, Paul
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Cockerill, H.
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Lopez Bernal, J.
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Linley, E.
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Borrow, Ray
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Brown, Kevin
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Ramsay, Mary Elizabeth
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Voysey, M.
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Snape, Matthew D.
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Ratcliffe, Helen
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Tiley, K.S.
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Andrews, Nick
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Amirthalingam, Gayatri
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Vichos, I.
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Morey, E.
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Douglas, N.L.
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Galiza, Eva P.
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Faust, Saul N.
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Roderick, Marion
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Lees, Tim
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Raman, M.
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Owens, Stephen
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Turner, Paul
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Cockerill, H.
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Linley, E.
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Borrow, Ray
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Brown, Kevin
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Ramsay, Mary Elizabeth
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Voysey, M.
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Snape, Matthew D.
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Ratcliffe, Helen, Tiley, K.S., Andrews, Nick, Amirthalingam, Gayatri, Vichos, I., Morey, E., Douglas, N.L., Marinou, S., Plested, Emma, Aley, Parvinder, Galiza, Eva P., Faust, Saul N., Hughes, S., Murray, Clare S., Roderick, Marion, Shackley, Fiona, Oddie, Sam J., Lees, Tim, Turner, D.P.J., Raman, M., Owens, Stephen, Turner, Paul, Cockerill, H., Lopez Bernal, J., Linley, E., Borrow, Ray, Brown, Kevin, Ramsay, Mary Elizabeth, Voysey, M. and Snape, Matthew D. (2022) Community seroprevalence of SARS-CoV-2 in children and adolescents in England, 2019-2021. Archives of Disease in Childhood, [archdischild-2022-324375]. (doi:10.1136/archdischild-2022-324375).

Record type: Article

Abstract

Objective: To 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. Design: We 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. Results: Post-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. Conclusions: Approximately 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 number: NCT04061382.

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Accepted/In Press date: 23 June 2022
e-pub ahead of print date: 20 July 2022
Published date: 20 July 2022
Additional Information: Funding Information: This research is funded by the National Institute for Health Research (NIHR) Policy Research Programme and the UK Research and Innovation (UKRI) Medical Research Council (PR-R17-0916-22001, CV220-036, CV220-036/1). The research is supported by the NIHR Oxford Clinical Research Facility and Biomedical Research Centre, the NIHR Clinical Research Network and the NIHR-funded National Immunisation Schedule Evaluation Consortium (PR-R17-0916-22001). The study sponsor is the University of Oxford. The processing of samples was completed by the COVID-19 serology team within Virus Reference Department at UKHSA. CSM is supported by NIHR Manchester BRC. Funding Information: MDS acts on behalf of the University of Oxford as an investigator on studies funded or sponsored by vaccine manufacturers, including AstraZeneca, GlaxoSmithKline, Pfizer, Novavax, Janssen, Medimmune and MCM. He receives no personal financial payment for this work. SNF acts on behalf of University Hospital Southampton National Health Service (NHS) Foundation Trust as an investigator or providing consultative advice, or both, on clinical trials and studies of COVID-19 and other vaccines funded or sponsored by vaccine manufacturers including Janssen, Pfizer, AstraZeneca, GlaxoSmithKline, Novavax, Seqirus, Sanofi, Medimmune, Merck and Valneva. He receives no personal financial payment for this work. MR and EL, through the Immunisation Department, provide vaccine manufacturers (including Pfizer) with post-marketing surveillance reports about pneumococcal and meningococcal disease which the companies are required to submit to the UK Licensing authority in compliance with their Risk Management Strategy. A cost recovery charge is made for these reports. PA acts on behalf of the University of Oxford as the director of operations at the Oxford Vaccine Group and has received funding from the Vaccine Taskforce via the NIHR and AstraZeneca. Publisher Copyright: © Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY. Published by BMJ.
Keywords: COVID-19, epidemiology, healthcare disparities, paediatrics

Identifiers

Local EPrints ID: 469541
URI: http://eprints.soton.ac.uk/id/eprint/469541
ISSN: 0003-9888
PURE UUID: c9337e44-9471-43d3-baf9-f89681649a75
ORCID for Saul N. Faust: ORCID iD orcid.org/0000-0003-3410-7642

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Date deposited: 16 Sep 2022 17:07
Last modified: 17 Mar 2024 03:06

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Contributors

Author: Helen Ratcliffe
Author: K.S. Tiley
Author: Nick Andrews
Author: Gayatri Amirthalingam
Author: I. Vichos
Author: E. Morey
Author: N.L. Douglas
Author: S. Marinou
Author: Emma Plested
Author: Parvinder Aley
Author: Eva P. Galiza
Author: Saul N. Faust ORCID iD
Author: S. Hughes
Author: Clare S. Murray
Author: Marion Roderick
Author: Fiona Shackley
Author: Sam J. Oddie
Author: Tim Lees
Author: D.P.J. Turner
Author: M. Raman
Author: Stephen Owens
Author: Paul Turner
Author: H. Cockerill
Author: J. Lopez Bernal
Author: E. Linley
Author: Ray Borrow
Author: Kevin Brown
Author: Mary Elizabeth Ramsay
Author: M. Voysey
Author: Matthew D. Snape

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