Extremely high SARS-CoV-2 seroprevalence in a strictly-Orthodox Jewish community in the UK

Abstract

Background Ethnic and religious minorities have been disproportionately affected by SARS-CoV-2 worldwide. The UK strictly-Orthodox Jewish community has been severely affected by the pandemic. This group shares characteristics with other ethnic minorities including larger family sizes, higher rates of household crowding and relative socioeconomic deprivation. We studied a UK strictly-Orthodox Jewish population to understand how COVID-19 had spread within this community. Methods We performed a household-focused cross-sectional SARS-CoV-2 serosurvey specific to three antigen targets. Randomly-selected households completed a standardised questionnaire and underwent serological testing with a multiplex assay for SARS-CoV-2 IgG antibodies. We report clinical illness and testing before the serosurvey, seroprevalence stratified by age and gender. We used random-effects models to identify factors associated with infection and antibody titres. Findings A total of 343 households, consisting of 1,759 individuals, were recruited. Serum was available for 1,242 participants. The overall seroprevalence for SARS-CoV-2 was 64.3% (95% CI 61.6-67.0%). The lowest seroprevalence was 27.6% in children under 5 years and rose to 73.8% in secondary school children and 74% in adults. Antibody titres were higher in symptomatic individuals and declined over time since reported COVID-19 symptoms, with the decline more marked for nucleocapsid titres. Interpretation In this tight-knit religious minority population in the UK, we report one of the highest SARS-CoV-2 seroprevalence levels in the world to date. In the context of this high force of infection, all age groups experienced a high burden of infection. Actions to reduce the burden of disease in this and other minority populations are urgently required.

How immunity from and interaction with seasonal coronaviruses can shape SARS-CoV-2 epidemiology

“…As the strength of interaction increased, the age-distribution flattened and a smaller proportion of children became infected. With complete protection, there was a higher rate in the youngest age groups, which has not been observed 19–21,28 .…”

“…Cross-protection from seasonal HCoVs may have, therefore, partially shaped the observed epidemiology of SARS-CoV-2. In particular, this cross-protection could help to explain the relatively low SARS-CoV-2 infection rate in children [17][18][19][20][21] . Since children likely have a higher annual attack rate of endemic HCoVs due to their higher contact rates 22 , they may be less susceptible to SARS-CoV-2 due to cross-protection.…”

Localising Vaccination Services: Qualitative Insights on an Orthodox Jewish Collaboration with Public health during the UK coronavirus Vaccine Programme

“…This qualitative research was conducted ancillary to a study examining rates of SARS-CoV-2 seroprevalence in a Haredi Jewish population in the UK. 4 Methods consisted of semi-structured informal interviews and discursive analysis of Haredi print media and social media pertaining to the UK national coronavirus vaccination programme. A key strand of the interviews focused on the involvement of ‘ Hatzola ’ in the provision of coronavirus vaccines.…”

“…Ethnic and religious minorities in England have been disproportionately affected by SARS-CoV-2 1 and are also widely reported to be less likely to accept vaccines offered as part of pandemic control measures. 2-3 High incidences of SARS-CoV-2 have been observed among Orthodox Jewish neighbourhoods in the UK, 4 the US, 5 and Israel. 6 This disproportionate burden of SARS-CoV-2 among Orthodox Jewish neighbourhoods should be understood against a backdrop of previous outbreaks of vaccine-preventable disease, especially measles, which have been attributed to suboptimal vaccination coverage rates.…”

Elevated Jewish Mortality from Coronavirus in England and Wales: An Epidemiological and Demographic Detective Story

“…Our assertions above should not be construed as a suggestion that this community had not been impacted by COVID-19 or, alternatively, that it had been impacted in a manner similar to, or different from, the rest of the Jewish community. In fact, prevalence of infection was shown to be very high among the British haredi: overall seroprevalence of 64%, in contrast to 7% nationally and 11% in London (Gaskell et al 2021). Simply, the very modest presence of the haredi in age groups relevant to the analysis of mortality means that the overall profile of COVID-19 mortality of Jews in Britain is shaped by the non-haredi.…”