Clinical Characteristics and Transmission of COVID-19 in Children and Youths During 3 Waves of Outbreaks in Hong Kong

Chua, Gilbert T.; Wong, Joshua Sung Chih; Lam, Ivan C.S.; Ho, Polly P. K.; Chan, Wai Hung; Yau, Felix Yat Sun; Duque, Jaime S. Rosa; Ho, Alvin Chi Chung; Siu, Ka Ka; Cheung, Tammy W Y; Lam, David Shu Yan; Chan, Victor C.M.; Lee, Kwok Piu; Tsui, Kwing Wan; Wong, Tak Wai; Yau, Man Mut; Yau, Tsz Yan; Chan, Kate Ching Ching; Yu, Michelle; Chow, Chit Kwong; Chiu, Wah; Chan, Kwok Chiu; Wong, Wilfred H. S.; Ho, Marco Hok Kung; Tso, Winnie W. Y.; Tung, Keith T. S.; Wong, Corine Sau Man; Kwok, Janette; Leung, Wing; Yam, Jason C.; Wong, Ian C K; Tam, Paul Kwong Hang; Chan, Godfrey Chi Fung; Chow, Chun Bong; To, Kelvin Kai‐Wang; Lau, Yu Lung; Yuen, Kwok Yung; Ip, Patrick; Kwan, Mike Yat Wah

doi:10.1001/jamanetworkopen.2021.8824

Cited by 56 publications

(47 citation statements)

References 29 publications

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“…Several studies that have examined the transmission of SARS-CoV-2 in children and adolescents have generally concluded that most infections in this age group result from household exposure rather than from exposure in a school setting. 18-21 Although the precise role of adolescents in the transmission of SARS-CoV-2 to adults is not known, it seems reasonable that widespread vaccination of this younger age group could further decrease community transmission and potentially contribute to herd immunity. 22 Therefore, a safe and effective vaccine in adolescents could reduce Covid-19–related morbidity and mortality.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of mRNA-1273 SARS-CoV-2 Vaccine in Adolescents

Ali¹,

et al. 2021

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Background The incidence of coronavirus disease 2019 (Covid-19) among adolescents between 12 and 17 years of age was approximately 900 per 100,000 population from April 1 through June 11, 2021. The safety, immunogenicity, and efficacy of the mRNA-1273 vaccine in adolescents are unknown. Methods In this ongoing phase 2–3, placebo-controlled trial, we randomly assigned healthy adolescents (12 to 17 years of age) in a 2:1 ratio to receive two injections of the mRNA-1273 vaccine (100 μg in each) or placebo, administered 28 days apart. The primary objectives were evaluation of the safety of mRNA-1273 in adolescents and the noninferiority of the immune response in adolescents as compared with that in young adults (18 to 25 years of age) in a phase 3 trial. Secondary objectives included the efficacy of mRNA-1273 in preventing Covid-19 or asymptomatic severe acute respiratory syndrome coronavirus 2 infection. Results A total of 3732 participants were randomly assigned to receive mRNA-1273 (2489 participants) or placebo (1243 participants). In the mRNA-1273 group, the most common solicited adverse reactions after the first or second injections were injection-site pain (in 93.1% and 92.4%, respectively), headache (in 44.6% and 70.2%, respectively), and fatigue (in 47.9% and 67.8%, respectively); in the placebo group, the most common solicited adverse reactions after the first or second injections were injection-site pain (in 34.8% or 30.3%, respectively), headache (in 38.5% and 30.2%, respectively), and fatigue (in 36.6% and 28.9%, respectively). No serious adverse events related to mRNA-1273 or placebo were noted. The geometric mean titer ratio of pseudovirus neutralizing antibody titers in adolescents relative to young adults was 1.08 (95% confidence interval [CI], 0.94 to 1.24), and the absolute difference in serologic response was 0.2 percentage points (95% CI, −1.8 to 2.4), which met the noninferiority criterion. No cases of Covid-19 with an onset of 14 days after the second injection were reported in the mRNA-1273 group, and four cases occurred in the placebo group. Conclusions The mRNA-1273 vaccine had an acceptable safety profile in adolescents. The immune response was similar to that in young adults, and the vaccine was efficacious in preventing Covid-19. (Funded by Moderna and the Biomedical Advanced Research and Development Authority; Teen COVE ClinicalTrials.gov number, NCT04649151 .)

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Section: Discussionmentioning

confidence: 99%

Evaluation of mRNA-1273 SARS-CoV-2 Vaccine in Adolescents

Ali¹,

et al. 2021

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“…Studies suggest that the evolution of SARS-CoV-2 genetic variants has influenced the transmission characteristics of each wave. For instance, strains of SARS-CoV-2 circulating during all three waves in Hong Kong, China were found to be different from each other [ 16 ]. These variants are broadly classified as variants of concern or variants of interest; each group differs in their transmissibility characteristics.…”

Section: Discussionmentioning

confidence: 99%

Current State of COVID-19 Pandemic in Africa: Lessons for Today and the Future

Obande

Bagudo

Mohamad

et al. 2021

IJERPH

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This study is a cross-sectional, observational analysis of the COVID-19 pandemic in Africa, to understand the progression of the disease across the continent. Published data on COVID-19 from 20 January 2020 to 21 June 2021 were obtained and analyzed. Case fatality ratios, as well as case growth rates and other indices were computed. On 21 June 2021, a total of 178,210,532 confirmed cases and 3,865,978 deaths had been recorded worldwide. While the Americas recorded the highest number of cases, Southern Africa recorded the majority of African cases. Fatality rate since from 20 February 2020 to 21 June 2021 was highest in the Americas (2.63%) and low in the South Eastern Asia region (1.39%), globally increasing from 2.17% at the end of January to 6.36% in May 2020 and decreasing to a range between 2.14% to 2.30% since January 2021. In Africa, the infection rate per 100,000 persons was up to 3090.18, while deaths per 100,000 and case fatality ratio were as high as 119.64 and 5.72%, respectively, among the 20 most-affected countries. The testing rate per million population was highest in Botswana (512,547.08). Fatality appears to be increasing in some regions of Africa. The rate of infection and fatality in Africa could still likely take an upward turn. Strict control measures are required, considering the continent’s weak healthcare systems.

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“…Using similar data and methodology, Auger and colleagues [ 11 ] also found that the incidence of COVID-19 and related mortality decreased with school closure, while Courtemanche and colleagues [ 12 ] found no association of school closure with the incidence of COVID-19 or with related mortality, but these studies failed to control for other voluntary behavior changes. A recent study of COVID-19 across three waves of the pandemic in Hong Kong revealed that transmission within schools was rare and concluded that the primary source of infection was through household members rather than schools [ 13 ]. A review of the literature on school closure and physical distancing measures found no data on the benefit of school closure on transmission relative to other measures and noted that modeling studies suggest that other physical distancing measures would be as effective [ 7 ••].…”

Section: Epidemiologic Considerations Of Covid-19 In Children and Implications For School Closurementioning

confidence: 99%

“…A review of the literature on school closure and physical distancing measures found no data on the benefit of school closure on transmission relative to other measures and noted that modeling studies suggest that other physical distancing measures would be as effective [ 7 ••]. These findings raise questions about both the need for, and potential benefit of, school closure and suggest that other approaches within schools (e.g., discontinuing non-essential activities, reducing class size, increasing the distance between students, and restricting children to contained cohorts; emphasizing hygiene; effective ventilation) [ 7 ••] and in communities (e.g., requiring mask wearing, travel restrictions) [ 13 ] may obviate the need for school closure in addressing the spread of the disease [ 7 ••, 13 ].…”

Section: Epidemiologic Considerations Of Covid-19 In Children and Implications For School Closurementioning

confidence: 99%

Challenges for Child Mental Health Raised by School Closure and Home Confinement During the COVID-19 Pandemic

Pfefferbaum

2021

Curr Psychiatry Rep

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Purpose of Review The closure of schools during the COVID-19 pandemic has interrupted the education of children worldwide. This paper reviews the psychological effects of this action on children and the impact on school-based services. Recent Findings Emerging epidemiologic findings have generated an intense debate about the need for, and potential benefit of, school closure in the context of COVID-19. International research reveals reactions in children that are not typically considered in the disaster literature as well as those that arise in other disasters. School closure also has curtailed the delivery of mental health services commonly offered in schools. Summary The debate about school closure will likely persist depending on local disease conditions and school readiness. Moreover, school closure is a possibility in future epidemics and pandemics and other disasters. The benefit of school closure must be balanced against the risk to children’s education and psychosocial development.

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Clinical Characteristics and Transmission of COVID-19 in Children and Youths During 3 Waves of Outbreaks in Hong Kong

Abstract: This cross-sectional study investigates the clinical characteristics and sources of infection of COVID-19 among children and youths in Hong Kong.

Cited by 56 publications

References 29 publications

Evaluation of mRNA-1273 SARS-CoV-2 Vaccine in Adolescents

Evaluation of mRNA-1273 SARS-CoV-2 Vaccine in Adolescents

Current State of COVID-19 Pandemic in Africa: Lessons for Today and the Future

Challenges for Child Mental Health Raised by School Closure and Home Confinement During the COVID-19 Pandemic

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