Risk of SARS-CoV-2 reinfections in children: a prospective national surveillance study between January, 2020, and July, 2021, in England

Mensah, Anna; Campbell, Helen; Stowe, Julia; Seghezzo, Giulia; Simmons, Ruth; Lacy, Joanne; Bukasa, Antoaneta; O’Boyle, Shennae; Ramsay, Mary; Brown, Kevin E.; Ladhani, Shamez

doi:10.1016/s2352-4642(22)00059-1

Cited by 47 publications

(50 citation statements)

References 29 publications

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“…Interestingly, when examining younger versus older age groups, we found that ages 5-11 exhibited no significant waning of naturally acquired protection throughout the outcome period, whereas waning protection in the 12-18 age group was more prominent, but still mild. This finding is consistent with previous observations that pointed to lower reinfection rates in children compared to adults, 14,15 and in younger children in particular. 37 It has been demonstrated that children have a different profile of immune response after a SARS-CoV-2 infection compared to adults, 38 though the biological paradigm that sufficiently explains this longer lasting protection requires further investigations.…”

Section: Discussionsupporting

confidence: 93%

“…Israel, an early adopter of the SARS-CoV-2 vaccine in adults, launched a vaccination campaign for adolescents on June, 2021, 11 (shortly after the BioNTech/Pfizer mRNA BNT162b2 vaccine was approved for adolescents by the United States Food and Drug Administration (FDA) and the European Medicines Agency in May 2021), 12,13 and for children ages 5-11 on November, 2021. Two studies that investigated the rates of recurrent infection in children reached similar conclusion; a study from California 14 found lower reinfection rates in children, as compared to adults, and similarly, a study from England 15 found a lower risk of reinfection in children. Nonetheless, the questions of waning of infection-induced-immunity, or the durability of protection, have yet to be answered.…”

Section: Introductionmentioning

confidence: 74%

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Naturally-acquired Immunity Dynamics against SARS-CoV-2 in Children and Adolescents

Patalon

Saciuk

Hadad

et al. 2022

Preprint

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ObjectivesThere are paucity of studies examining naturally acquired immunity against SARS-CoV-2 in children and adolescents, though they are generally the last group to be afforded the vaccine, and a significant portion of them are still unvaccinated. This study examined the duration of protection conferred by a previous SARS-CoV-2 infection amongst children and adolescents.DesignA retrospective study, applying two complementary approaches: a matched test-negative case control design and a retrospective cohort design.SettingNationally centralized database of Maccabi Healthcare Services, an Israeli national health fund that covers 2.5 million people.ParticipantsThe study population included between 293,743 and 458,959 individuals (depending on the model), 5-18 years of age, who were unvaccinated SARS-CoV-2 naïve persons or unvaccinated convalescent patients.Main outcomes and measuresAnalyses focused on the period of July 1 to December 13, 2021, a Delta-dominant period in Israel. We evaluated three SARS-CoV-2-related outcomes: (1) documented PCR confirmed infection or reinfection, (2) COVID-19 and (3) severe COVID-19.ResultsOverall, children and adolescents who were previously infected acquired durable protection against reinfection (symptomatic or not) with SARS-CoV-2 for at least 18 months. Importantly, no COVID-19 related deaths were recorded in either the SARS-CoV-2 naïve group or the previously infected group. Effectiveness of naturally-acquired immunity against a recurrent infection reached 89.2% (95% CI: 84.7%-92.4%) three to six months after first infection, mildly declining to 82.5% (95% CI, 79.1%-85.3%) nine months to one year after infection, then remaining rather steady for children and adolescents for up to 18 months, with a slight non-significant waning trend. Additionally, we found that ages 5-11 exhibited no significant waning of naturally acquired protection throughout the outcome period, whereas waning protection in the 12-18 age group was more prominent, but still mild.ConclusionsChildren and adolescents who were previously infected with SARS-CoV-2 remain protected against reinfection to a high degree for 18 months. Policy decision makers should consider when and if convalescent children and adolescents should be vaccinated. Nonetheless, further research is needed to examine naturally acquired immunity against emerging variants, including the Omicron.

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Section: Discussionsupporting

confidence: 93%

Section: Introductionmentioning

confidence: 74%

Naturally-acquired Immunity Dynamics against SARS-CoV-2 in Children and Adolescents

Patalon

Saciuk

Hadad

et al. 2022

Preprint

View full text Add to dashboard Cite

show abstract

“…Several studies in infected or vaccinated individuals based on the humoral antibody SARS-CoV-2 responses have reported a reduction in the neutralizing antibody titers to the Omicron variant in comparison to the wild-type SARS-CoV-2 [54] , [55] . Moreover, SARS-CoV-2 reinfections seem to be less severe than the first one both in children [56] and adults [57] and even in solid organ transplant (SOT) patients [58] .…”

Section: Omicron and Ade: Foreseen Risksmentioning

confidence: 99%

Non-neutralizing antibodies: Deleterious or propitious during SARS-CoV-2 infection?

Zanella

Antoni

Marchese

et al. 2022

International Immunopharmacology

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“…The Article by Anna A Mensah and colleagues 1 addresses the important question of COVID-19 in children and the risk of reinfection over time in England. These data were collected before the emergence of the omicron variant of concern in England, but provide helpful insights into the overall picture of COVID-19, which has been quite different in children when compared with adults.…”

mentioning

confidence: 99%

“… 7 However, an important key finding of Mensah and colleagues' study is that reinfection with SARS-CoV-2 was not associated with fatal paediatric cases. 1 …”

mentioning

confidence: 99%

Importance of understanding the reinfection risk of COVID-19 in children

Crawford

2022

The Lancet Child & Adolescent Health

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Risk of SARS-CoV-2 reinfections in children: a prospective national surveillance study between January, 2020, and July, 2021, in England

Cited by 47 publications

References 29 publications

Naturally-acquired Immunity Dynamics against SARS-CoV-2 in Children and Adolescents

Naturally-acquired Immunity Dynamics against SARS-CoV-2 in Children and Adolescents

Non-neutralizing antibodies: Deleterious or propitious during SARS-CoV-2 infection?

Importance of understanding the reinfection risk of COVID-19 in children

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