Surge in SARS-CoV-2 transmission in school-aged children and household contacts, England, August to October 2021

Chudasama, Dimple; Tessier, Elise; Flannagan, Joe; Leeman, David; Webster, Harriet; Demirjian, Alicia; Falconer, Catherine; Thelwall, Simon; Kall, Meaghan; Saliba, Vanessa; Ramsay, Mary; Dabrera, Gavin; Lamagni, Theresa

doi:10.2807/1560-7917.es.2021.26.48.2101019

Cited by 16 publications

(18 citation statements)

References 11 publications

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“…However, it is also well established that the school environment is historically associated with a high transmission risk for many respiratory pathogens [ 35 – 39 ], simply due to the large number of pupils and the high number of contacts involved [ 40 – 42 ]. The data from England suggests that (before the emergence of the Omicron variant) there had not been the type of explosive outbreaks of SARS-CoV-2 within schools that are frequently associated with other respiratory diseases [ 43 – 46 ]; yet it is evident that transmission does occur within schools [ 47 – 49 ] and 2021 saw pronounced increases in school-aged infection in England [ 45 , 50 ].…”

Section: Introductionmentioning

confidence: 99%

An assessment of the vaccination of school-aged children in England against SARS-CoV-2

Keeling

Moore

2022

BMC Med

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Background Children and young persons are known to have a high number of close interactions, often within the school environment, which can facilitate rapid spread of infection; yet for SARS-CoV-2, it is the elderly and vulnerable that suffer the greatest health burden. Vaccination, initially targeting the elderly and vulnerable before later expanding to the entire adult population, has been transformative in the control of SARS-CoV-2 in England. However, early concerns over adverse events and the lower risk associated with infection in younger individuals means that the expansion of the vaccine programme to those under 18 years of age needs to be rigorously and quantitatively assessed. Methods Here, using a bespoke mathematical model matched to case and hospital data for England, we consider the potential impact of vaccinating 12–17 and 5–11-year-olds. This analysis is reported from an early model (generated in June 2021) that formed part of the evidence base for the decisions in England, and a later model (from November 2021) that benefits from a richer understanding of vaccine efficacy, greater knowledge of the Delta variant wave and uses data on the rate of vaccine administration. For both models, we consider the population wide impact of childhood vaccination as well as the specific impact on the age groups targeted for vaccination. Results Projections from June suggested that an expansion of the vaccine programme to those 12–17 years old could generate substantial reductions in infection, hospital admission and deaths in the entire population, depending on population behaviour following the relaxation of control measures. The benefits within the 12–17-year-old cohort were less marked, saving between 660 and 1100 (95% PI (prediction interval) 280–2300) hospital admissions and between 22 and 38 (95% PI 9–91) deaths depending on assumed population behaviour. For the more recent model, the benefits within this age group are reduced, saving on average 630 (95% PI 300–1300) hospital admissions and 11 (95% PI 5–28) deaths for 80% vaccine uptake, while the benefits to the wider population represent a reduction of 8–10% in hospital admissions and deaths. The vaccination of 5–11-year-olds is projected to have a far smaller impact, in part due to the later roll-out of vaccines to this age group. Conclusions Vaccination of 12–170-year-olds and 5–11-year-olds is projected to generate a reduction in infection, hospital admission and deaths for both the age groups involved and the population in general. For any decision involving childhood vaccination, these benefits needs to be balanced against potential adverse events from the vaccine, the operational constraints on delivery and the potential for diverting resources from other public health campaigns.

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Section: Introductionmentioning

confidence: 99%

An assessment of the vaccination of school-aged children in England against SARS-CoV-2

Keeling

Moore

2022

BMC Med

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“…Transmission in schools might well alter when interventions relax, and when more transmissible variants arise, as occurred in late 2021. 31 Secondly, participation rates of contacts were very low, compared with participation rates of higher than 40% in our earlier contact tracing study 14 also involving throat swabs, lowering confidence in ruling out any bubble transmission. Low participation is reported in other studies in England that detect asymptomatic SARS-CoV-2 infections, 32 contrasting with high participation in Nordic countries.…”

Section: Discussionmentioning

confidence: 76%

Transmission of SARS-CoV-2 by children to contacts in schools and households: a prospective cohort and environmental sampling study in London

Cordery¹,

Reeves

Zhou

et al. 2022

The Lancet Microbe

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“…Real-time polymerase chain reaction (RT-PCR) was used in 17 studies to diagnose COVID-19. In seven studies, serology tests were performed in addition to or instead of RT-PCR (10, 14, 22, 23, 26, 29, 32, 33), while in the remaining study, Nucleic Acid Amplification Test (NAAT) was reported as the single diagnostic method for SARS-CoV-2 detection (25). Regarding NPIs, case isolation and quarantine of contacts were the most frequently reported measures and implemented in parallel with the contact tracing investigations for mitigating/suppressing SARS-CoV-2 transmission during the pandemic..…”

Section: Resultsmentioning

confidence: 99%

A systematic review on outbreaks of COVID-19 among children within households in the European region

Vardavas

Nikitara

Aslanoglou

et al. 2022

Preprint

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Objectives: This systematic review aims to identify the secondary attack rates (SAR) to adults and other children when children are the index cases within household settings. Methods: This literature review assessed European-based studies published in Medline and Embase between January 2020 and January 2022 that assessed the secondary transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) within household settings. The inclusion criteria were based on the PEO framework (P-Population, E-Exposure, O-Outcome) for systematic reviews. Thus, the study population was restricted to humans within the household setting in Europe (population), in contact with pediatric index cases 1 to 17 years old (exposure) that led to the transmission of SARS-CoV-2 reported as either a SAR or the probability of onward infection (outcome). Results: Of 1,819 studies originally identified, 25 met the inclusion criteria. Overall, the SAR ranged from 13% to 75% in 23 studies, while there was no evidence of secondary transmission from children to other household members in two studies. Evidence indicated that asymptomatic SARS-CoV-2 index cases also have a lower SAR than those with symptoms and that younger children may have a lower SAR than adolescents (>12 years old) within household settings. Conclusions: SARS-CoV-2 secondary transmission from paediatric index cases ranged from 0% to 75%, within household settings between January 2020 and January 2022, with differences noted by age and by symptomatic/asymptomatic status of the index case. Given the anticipated endemic circulation of SARS-CoV-2, continued monitoring and assessment of household transmission is necessary.

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Surge in SARS-CoV-2 transmission in school-aged children and household contacts, England, August to October 2021

Cited by 16 publications

References 11 publications

An assessment of the vaccination of school-aged children in England against SARS-CoV-2

An assessment of the vaccination of school-aged children in England against SARS-CoV-2

Transmission of SARS-CoV-2 by children to contacts in schools and households: a prospective cohort and environmental sampling study in London

A systematic review on outbreaks of COVID-19 among children within households in the European region

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