1
|
Soriano López J, Gómez Gómez JH, Ballesta-Ruiz M, Garcia-Pina R, Sánchez-Rodríguez I, Bonilla-Escobar BA, Salmerón D, Rodríguez BS, Chirlaque MD. COVID-19, social determinants of transmission in the home. A population-based study. Eur J Public Health 2024:ckae016. [PMID: 38396184 DOI: 10.1093/eurpub/ckae016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/25/2024] Open
Abstract
BACKGROUND Studying transmission within the home is essential to understand the transmission dynamics of numerous infectious diseases. For Coronavirus Disease-2019 (COVID-19), transmission within the home constitutes the majority exposure context. The risk of infection in this setting can be quantified by the household/intra-family secondary attack rate (SAR). In the literature, there are discrepancies in these values and little information about its social determinants. The aim of this study was to investigate transmission in the home by analyzing the influence of occupational social class, country of origin and gender/sex. METHODS This was a retrospective cohort study of a population registry of cohabiting contacts with COVID-19 cases diagnosed from 15 June to 23 December 2020, in the Murcia Region. The household SAR was analyzed considering the characteristics of the primary case (sex, age, symptoms, occupational social class, country of origin and number of people in the household) and contact (age and sex) using a multilevel binary logistic regression model. RESULTS Among the 37 727 contacts included, the intra-family SAR was 39.1%. The contacts of confirmed primary cases in the migrant population (Africa and Latin America) had higher attack rates, even after adjusting for the other variables. Older age and female sex were independent risk factors for contracting Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) within the home. CONCLUSION There was greater intra-domiciliary transmission among immigrants, likely related to the conditions of the home and situation of social vulnerability. Women were more likely to be infected by transmission from a cohabiting infected individual.
Collapse
Affiliation(s)
- Jesús Soriano López
- Murcia Region Health Department, Murcia, Spain
- Teaching Unit of Preventive Medicine and Public Health, Murcia, Spain
| | - Jesús Humberto Gómez Gómez
- Murcia Region Health Department, Murcia, Spain
- Department of Epidemiology, Murcia, Spain
- CIBER in Epidemiology and Public Health (CIBERESP), Madrid, Spain
- IMIB Arrixaca, Murcia, Spain
| | - Monica Ballesta-Ruiz
- Murcia Region Health Department, Murcia, Spain
- Department of Epidemiology, Murcia, Spain
- IMIB Arrixaca, Murcia, Spain
- Division of Preventive Medicine and Public Health, Department of Public Health Sciences, University of Murcia, Murcia, Spain
| | - Rocio Garcia-Pina
- Murcia Region Health Department, Murcia, Spain
- Planning and Health Financing Department, Murcia, Spain
| | - Inés Sánchez-Rodríguez
- Murcia Region Health Department, Murcia, Spain
- Department of Epidemiology, Murcia, Spain
- IMIB Arrixaca, Murcia, Spain
| | - Bertha A Bonilla-Escobar
- Government of Spain Ministry of Health, Health Promotion and Equity Area, Deputy Directorate General for Health Promotion and Prevention, Directorate General for Public Madrid, Comunidad de Madrid, Madrid, Spain
- TRAGSATEC, Management of Health, Food Safety and Public Health Madrid, Comunidad de Madrid, Madrid, Spain
| | - Diego Salmerón
- CIBER in Epidemiology and Public Health (CIBERESP), Madrid, Spain
- IMIB Arrixaca, Murcia, Spain
- Department of Health & Social Sciences, University of Murcia, Murcia, Spain
| | - Berta Suárez Rodríguez
- CIBER in Epidemiology and Public Health (CIBERESP), Madrid, Spain
- Government of Spain Ministry of Health, Spain Centre for Health Alerts and Emergencies, Directorate General of Public Health, Ministry of Health Madrid, Comunidad de Madrid, Madrid, Spain
| | - Maria-Dolores Chirlaque
- Murcia Region Health Department, Murcia, Spain
- Department of Epidemiology, Murcia, Spain
- CIBER in Epidemiology and Public Health (CIBERESP), Madrid, Spain
- IMIB Arrixaca, Murcia, Spain
- Division of Preventive Medicine and Public Health, Department of Public Health Sciences, University of Murcia, Murcia, Spain
| |
Collapse
|
2
|
Kim M, Cheng WA, Congrave-Wilson Z, Marentes Ruiz CJ, Turner L, Mendieta S, Jumarang J, Del Valle J, Lee Y, Fabrizio T, Allen EK, Thomas PG, Webby R, Gordon A, Pannaraj PS. Comparisons of Pediatric and Adult SARS-CoV-2-Specific Antibodies up to 6 Months after Infection, Vaccination, or Hybrid Immunity. J Pediatric Infect Dis Soc 2024; 13:91-99. [PMID: 38016076 PMCID: PMC10824260 DOI: 10.1093/jpids/piad107] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Accepted: 11/27/2023] [Indexed: 11/30/2023]
Abstract
BACKGROUND Characterization of longitudinal SARS-CoV-2-specific antibody responses in children following infection and vaccination is needed to inform SARS-CoV-2 vaccine policy decisions for children, which may differ from adults. METHODS We enrolled individuals at the time of SARS-CoV-2 infection or vaccination for longitudinal serological testing and compared SARS-CoV-2-spike-specific IgG and neutralization activity in children and adults stratified by infection and vaccination status using enzyme-linked immunosorbent and virus neutralization assays. RESULTS Between June 2020 and December 2022, we collected sera from 669 participants aged 40 days to 55 years, including 330 unvaccinated individuals with laboratory-confirmed SARS-CoV-2 infection, 180 vaccinated SARS-CoV-2-naïve individuals, and 159 vaccinated previously infected individuals. Half (n = 330, 49.3%) were children. SARS-CoV-2-specific IgG and neutralization activity in children < 12 years old in response to infection persisted at higher levels than those of adults through at least 6 months (spike-specific IgG levels, 2.05 [95% CI: 1.4-3.1] times higher than adults; neutralizing activity, median 88.8 vs 75.2%, respectively, p = .04). In addition, all pediatric participants had significantly higher IgG levels compared with adults at 6 months following infection or vaccination, regardless of prior infection status. Vaccine-induced SARS-CoV-2-specific IgG responses in previously infected individuals persisted at higher levels than those from infection alone at 6 months (median AUC, children 5-11 years old, 9115 vs 368; adolescents 3613 vs 475; adults 1956 vs 263, all p < .001). CONCLUSIONS These data demonstrate the robust and persistent immunologic response of SARS-CoV-2 vaccination in children and emphasize the benefit of vaccination after SARS-CoV-2 infection.
Collapse
Affiliation(s)
- Minjun Kim
- Division of Infectious Diseases, Department of Pediatrics, University of California San Diego, San Diego, CA, USA
| | - Wesley A Cheng
- Division of Infectious Diseases, Department of Pediatrics, University of California San Diego, San Diego, CA, USA
| | - Zion Congrave-Wilson
- Division of Infectious Diseases, Children’s Hospital Los Angeles, Los Angeles, CA, USA
| | | | - Lauren Turner
- Division of Infectious Diseases, Children’s Hospital Los Angeles, Los Angeles, CA, USA
| | - Shirley Mendieta
- Division of Infectious Diseases, Department of Pediatrics, University of California San Diego, San Diego, CA, USA
| | - Jaycee Jumarang
- Division of Infectious Diseases, Department of Pediatrics, University of California San Diego, San Diego, CA, USA
| | - Jennifer Del Valle
- Division of Infectious Diseases, Children’s Hospital Los Angeles, Los Angeles, CA, USA
| | - Yesun Lee
- Division of Infectious Diseases, Department of Pediatrics, University of California San Diego, San Diego, CA, USA
| | - Thomas Fabrizio
- Department of Infectious Diseases, St Jude Children’s Research Hospital, Memphis, TN, USA
| | - E Kaitlynn Allen
- Department of Immunology, St. Jude Children’s Research Hospital, Memphis, TN, USA
| | - Paul G Thomas
- Department of Immunology, St. Jude Children’s Research Hospital, Memphis, TN, USA
| | - Richard Webby
- Department of Infectious Diseases, St Jude Children’s Research Hospital, Memphis, TN, USA
| | - Aubree Gordon
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, USA
| | - Pia S Pannaraj
- Division of Infectious Diseases, Department of Pediatrics, University of California San Diego, San Diego, CA, USA
- Division of Infectious Diseases, Rady Children’s Hospital, San Diego, CA, USA
| |
Collapse
|
3
|
Chung MK, Hart B, Santillana M, Patel CJ. Pediatric and Young Adult Household Transmission of the Initial Waves of SARS-CoV-2 in the United States: Administrative Claims Study. J Med Internet Res 2024; 26:e44249. [PMID: 37967280 PMCID: PMC10768807 DOI: 10.2196/44249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Revised: 07/18/2023] [Accepted: 10/29/2023] [Indexed: 11/17/2023] Open
Abstract
BACKGROUND The correlates responsible for the temporal changes of intrahousehold SARS-CoV-2 transmission in the United States have been understudied mainly due to a lack of available surveillance data. Specifically, early analyses of SARS-CoV-2 household secondary attack rates (SARs) were small in sample size and conducted cross-sectionally at single time points. From these limited data, it has been difficult to assess the role that different risk factors have had on intrahousehold disease transmission in different stages of the ongoing COVID-19 pandemic, particularly in children and youth. OBJECTIVE This study aimed to estimate the transmission dynamic and infectivity of SARS-CoV-2 among pediatric and young adult index cases (age 0 to 25 years) in the United States through the initial waves of the pandemic. METHODS Using administrative claims, we analyzed 19 million SARS-CoV-2 test records between January 2020 and February 2021. We identified 36,241 households with pediatric index cases and calculated household SARs utilizing complete case information. Using a retrospective cohort design, we estimated the household SARS-CoV-2 transmission between 4 index age groups (0 to 4 years, 5 to 11 years, 12 to 17 years, and 18 to 25 years) while adjusting for sex, family size, quarter of first SARS-CoV-2 positive record, and residential regions of the index cases. RESULTS After filtering all household records for greater than one member in a household and missing information, only 36,241 (0.85%) of 4,270,130 households with a pediatric case remained in the analysis. Index cases aged between 0 and 17 years were a minority of the total index cases (n=11,484, 11%). The overall SAR of SARS-CoV-2 was 23.04% (95% CI 21.88-24.19). As a comparison, the SAR for all ages (0 to 65+ years) was 32.4% (95% CI 32.1-32.8), higher than the SAR for the population between 0 and 25 years of age. The highest SAR of 38.3% was observed in April 2020 (95% CI 31.6-45), while the lowest SAR of 15.6% was observed in September 2020 (95% CI 13.9-17.3). It consistently decreased from 32% to 21.1% as the age of index groups increased. In a multiple logistic regression analysis, we found that the youngest pediatric age group (0 to 4 years) had 1.69 times (95% CI 1.42-2.00) the odds of SARS-CoV-2 transmission to any family members when compared with the oldest group (18 to 25 years). Family size was significantly associated with household viral transmission (odds ratio 2.66, 95% CI 2.58-2.74). CONCLUSIONS Using retrospective claims data, the pediatric index transmission of SARS-CoV-2 during the initial waves of the COVID-19 pandemic in the United States was associated with location and family characteristics. Pediatric SAR (0 to 25 years) was less than the SAR for all age other groups. Less than 1% (n=36,241) of all household data were retained in the retrospective study for complete case analysis, perhaps biasing our findings. We have provided measures of baseline household pediatric transmission for tracking and comparing the infectivity of later SARS-CoV-2 variants.
Collapse
Affiliation(s)
- Ming Kei Chung
- Department of Biomedical Informatics, Harvard Medical School, Harvard University, Boston, MA, United States
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China (Hong Kong)
- Institute of Environment, Energy, and Sustainability, The Chinese University of Hong Kong, Hong Kong, China (Hong Kong)
| | - Brian Hart
- Optum Labs, Eden Prairie, MN, United States
| | - Mauricio Santillana
- Machine Intelligence Group for the Betterment of Health and the Environment, Network Science Institute, Northeastern University, Boston, MA, United States
| | - Chirag J Patel
- Department of Biomedical Informatics, Harvard Medical School, Harvard University, Boston, MA, United States
| |
Collapse
|
4
|
Goh M, Joy C, Gillespie AN, Soh QR, He F, Sung V. Asymptomatic viruses detectable in saliva in the first year of life: a narrative review. Pediatr Res 2024; 95:508-531. [PMID: 38135726 DOI: 10.1038/s41390-023-02952-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 11/15/2023] [Accepted: 11/20/2023] [Indexed: 12/24/2023]
Abstract
Viral infections are common in children. Many can be asymptomatic or have delayed health consequences. In view of increasing availability of point-of-care viral detection technologies, with possible application in newborn screening, this review aimed to (1) identify potentially asymptomatic viruses detectable in infants under one year old, via saliva/nasopharyngeal swab, and (2) describe associations between viruses and long-term health conditions. We systematically searched Embase(Ovid), Medline(Ovid) and PubMed, then further searched the literature in a tiered approach. From the 143 articles included, 28 potentially asymptomatic viruses were identified. Our second search revealed associations with a range of delayed health conditions, with most related to the severity of initial symptoms. Many respiratory viruses were linked with development of recurrent wheeze or asthma. Of note, some potentially asymptomatic viruses are linked with later non-communicable diseases: adenovirus serotype 36 and obesity, Enterovirus-A71 associated Hand, Foot, Mouth Disease and Attention-Deficit Hyperactivity Disorder, Ebstein Barr Virus (EBV) and malignancy, EBV and multiple sclerosis, HHV-6 and epilepsy, HBoV-1 and lung fibrosis and Norovirus and functional gastrointestinal disorders. Our review identified many potentially asymptomatic viruses, detectable in early life with potential delayed health consequences, that could be important to screen for in the future using rapid point-of-care viral detection methods. IMPACT: Novel point-of-care viral detection technologies enable rapid detection of viruses, both old and emerging. In view of increasing capability to screen for viruses, this is the first review to explore which potentially asymptomatic viruses, that are detectable using saliva and/or nasopharyngeal swabs in infants less than one year of age, are associated with delayed adverse health conditions. Further research into detecting such viruses in early life and their delayed health outcomes may pave new ways to prevent non-communicable diseases in the future.
Collapse
Affiliation(s)
- Melody Goh
- Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, VIC, Australia
- Prevention Innovation, Murdoch Children's Research Institute, Parkville, VIC, Australia
| | - Charissa Joy
- Prevention Innovation, Murdoch Children's Research Institute, Parkville, VIC, Australia
- Monash Children's Hospital Clayton, Clayton, VIC, Australia
| | - Alanna N Gillespie
- Prevention Innovation, Murdoch Children's Research Institute, Parkville, VIC, Australia
- Centre for Community Child Health, The Royal Children's Hospital, Parkville, VIC, Australia
| | - Qi Rui Soh
- Prevention Innovation, Murdoch Children's Research Institute, Parkville, VIC, Australia
- The University of Melbourne, Faculty of Medicine Dentistry and Health Sciences Melbourne, Melbourne, VIC, Australia
| | - Fan He
- Prevention Innovation, Murdoch Children's Research Institute, Parkville, VIC, Australia
- John Richards Centre for Rural Ageing Research, La Trobe University, Wodonga, VIC, Australia
| | - Valerie Sung
- Prevention Innovation, Murdoch Children's Research Institute, Parkville, VIC, Australia.
- Monash Children's Hospital Clayton, Clayton, VIC, Australia.
- Department of Paediatrics, The University of Melbourne, Parkville, VIC, Australia.
| |
Collapse
|
5
|
Galmiche S, Charmet T, Madec Y, Rakover A, Schaeffer L, Chény O, Omar F, Martin S, Mailles A, Carrat F, Fontanet A. Reduction of SARS-CoV-2 intra-household child-to-parent transmission associated with ventilation: results from a case-control study. BMC Public Health 2023; 23:1240. [PMID: 37365557 DOI: 10.1186/s12889-023-16144-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Accepted: 06/18/2023] [Indexed: 06/28/2023] Open
Abstract
PURPOSE Our objective was to describe circumstances of SARS-CoV-2 household transmission and to identify factors associated with a lower risk of transmission in a nationwide case-control study in France. METHODS In a descriptive analysis, we analysed cases reporting transmission from someone in the household (source case). Index cases could invite a non-infected household member to participate as a related control. In such situations, we compared the exposures of the index case and related control to the source case by conditional logistic regression matched for household, restricted to households in which the source case was a child, and the index case and related control were the infected child's parents. RESULTS From October 27, 2020 to May 16, 2022, we included 104 373 cases for the descriptive analysis with a documented infection from another household member. The source case was mostly the index case's child (46.9%) or partner (45.7%). In total, 1026 index cases invited a related control to participate in the study. In the case-control analysis, we included 611 parental pairs of cases and controls exposed to the same infected child. COVID-19 vaccination with 3 + doses versus no vaccination (OR 0.1, 95%CI: 0.04-0.4), isolation from the source case (OR 0.6, 95%CI: 0.4-0.97) and the ventilation of indoor areas (OR 0.6, 95%CI: 0.4-0.9) were associated with lower risk of infection. CONCLUSION Household transmission was common during the SARS-CoV-2 pandemic in France. Mitigation strategies, including isolation and ventilation, decreased the risk of secondary transmission within the household. TRIAL REGISTRATION ClinicalTrials.gov registration number: NCT04607941.
Collapse
Affiliation(s)
- Simon Galmiche
- Emerging Diseases Epidemiology Unit, Institut Pasteur, Université Paris Cité, 25 rue du Docteur Roux, Paris, 75015, France
- Sorbonne Université, Ecole Doctorale Pierre Louis de Santé Publique, Paris, France
| | - Tiffany Charmet
- Emerging Diseases Epidemiology Unit, Institut Pasteur, Université Paris Cité, 25 rue du Docteur Roux, Paris, 75015, France
| | - Yoann Madec
- Emerging Diseases Epidemiology Unit, Institut Pasteur, Université Paris Cité, 25 rue du Docteur Roux, Paris, 75015, France
| | - Arthur Rakover
- Emerging Diseases Epidemiology Unit, Institut Pasteur, Université Paris Cité, 25 rue du Docteur Roux, Paris, 75015, France
| | - Laura Schaeffer
- Emerging Diseases Epidemiology Unit, Institut Pasteur, Université Paris Cité, 25 rue du Docteur Roux, Paris, 75015, France
| | - Olivia Chény
- Institut Pasteur, Université Paris Cité, Centre for Translational Research, Paris, France
| | | | - Sophie Martin
- Caisse Nationale de L'Assurance Maladie, Paris, France
| | | | - Fabrice Carrat
- Sorbonne Université, Inserm, IPLESP, Hôpital Saint-Antoine, AP-HP, Paris, France
| | - Arnaud Fontanet
- Emerging Diseases Epidemiology Unit, Institut Pasteur, Université Paris Cité, 25 rue du Docteur Roux, Paris, 75015, France.
- Conservatoire National Des Arts Et Métiers, Unité PACRI, Paris, France.
| |
Collapse
|
6
|
Tseng YJ, Olson KL, Bloch D, Mandl KD. Smart Thermometer-Based Participatory Surveillance to Discern the Role of Children in Household Viral Transmission During the COVID-19 Pandemic. JAMA Netw Open 2023; 6:e2316190. [PMID: 37261828 PMCID: PMC10236238 DOI: 10.1001/jamanetworkopen.2023.16190] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 04/18/2023] [Indexed: 06/02/2023] Open
Abstract
Importance Children's role in spreading virus during the COVID-19 pandemic is yet to be elucidated, and measuring household transmission traditionally requires contact tracing. Objective To discern children's role in household viral transmission during the pandemic when enveloped viruses were at historic lows and the predominance of viral illnesses were attributed to COVID-19. Design, Setting, and Participants This cohort study of a voluntary US cohort tracked data from participatory surveillance using commercially available thermometers with a companion smartphone app from October 2019 to October 2022. Eligible participants were individuals with temperature measurements in households with multiple members between October 2019 and October 2022 who opted into data sharing. Main Outcomes and Measures Proportion of household transmissions with a pediatric index case and changes in transmissions during school breaks were assessed using app and thermometer data. Results A total of 862 577 individuals from 320 073 households with multiple participants (462 000 female [53.6%] and 463 368 adults [53.7%]) were included. The number of febrile episodes forecast new COVID-19 cases. Within-household transmission was inferred in 54 506 (15.4%) febrile episodes and increased from the fourth pandemic period, March to July 2021 (3263 of 32 294 [10.1%]) to the Omicron BA.1/BA.2 wave (16 516 of 94 316 [17.5%]; P < .001). Among 38 787 transmissions in 166 170 households with adults and children, a median (IQR) 70.4% (61.4%-77.6%) had a pediatric index case; proportions fluctuated weekly from 36.9% to 84.6%. A pediatric index case was 0.6 to 0.8 times less frequent during typical school breaks. The winter break decrease was from 68.4% (95% CI, 57.1%-77.8%) to 41.7% (95% CI, 34.3%-49.5%) at the end of 2020 (P < .001). At the beginning of 2022, it dropped from 80.3% (95% CI, 75.1%-84.6%) to 54.5% (95% CI, 51.3%-57.7%) (P < .001). During summer breaks, rates dropped from 81.4% (95% CI, 74.0%-87.1%) to 62.5% (95% CI, 56.3%-68.3%) by August 2021 (P = .02) and from 83.8% (95% CI, 79.2%-87.5) to 62.8% (95% CI, 57.1%-68.1%) by July 2022 (P < .001). These patterns persisted over 2 school years. Conclusions and Relevance In this cohort study using participatory surveillance to measure within-household transmission at a national scale, we discerned an important role for children in the spread of viral infection within households during the COVID-19 pandemic, heightened when schools were in session, supporting a role for school attendance in COVID-19 spread.
Collapse
Affiliation(s)
- Yi-Ju Tseng
- Computational Health Informatics Program, Boston Children’s Hospital, Boston, Massachusetts
- Department of Computer Science, National Yang Ming Chiao Tung University, Hsinchu, Taiwan
| | - Karen L. Olson
- Computational Health Informatics Program, Boston Children’s Hospital, Boston, Massachusetts
- Department of Pediatrics, Harvard Medical School, Boston, Massachusetts
| | | | - Kenneth D. Mandl
- Computational Health Informatics Program, Boston Children’s Hospital, Boston, Massachusetts
- Department of Pediatrics, Harvard Medical School, Boston, Massachusetts
- Department of Biomedical Informatics, Harvard Medical School, Boston, Massachusetts
| |
Collapse
|
7
|
Zhu Y, Xia Y, Pickering J, Bowen AC, Short KR. The role of children in transmission of SARS-CoV-2 variants of concern within households: an updated systematic review and meta-analysis, as at 30 June 2022. Euro Surveill 2023; 28:2200624. [PMID: 37140450 PMCID: PMC10161681 DOI: 10.2807/1560-7917.es.2023.28.18.2200624] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Accepted: 03/17/2023] [Indexed: 05/05/2023] Open
Abstract
BackgroundMeta-analyses and single-site studies have established that children are less infectious than adults within a household when positive for ancestral SARS-CoV-2. In addition, children appear less susceptible to infection when exposed to ancestral SARS-CoV-2 within a household. The emergence of SARS-CoV-2 variants of concern (VOC) has been associated with an increased number of paediatric infections worldwide. However, the role of children in the household transmission of VOC, relative to the ancestral virus, remains unclear.AimWe aimed to evaluate children's role in household transmission of SARS-CoV-2 VOC.MethodsWe perform a meta-analysis of the role of children in household transmission of both ancestral SARS-CoV-2 and SARS-CoV-2 VOC.ResultsUnlike with the ancestral virus, children infected with VOC spread SARS-CoV-2 to an equivalent number of household contacts as infected adults and were equally as likely to acquire SARS-CoV-2 VOC from an infected family member. Interestingly, the same was observed when unvaccinated children exposed to VOC were compared with unvaccinated adults exposed to VOC.ConclusionsThese data suggest that the emergence of VOC was associated with a fundamental shift in the epidemiology of SARS-CoV-2. It is unlikely that this is solely the result of age-dependent differences in vaccination during the VOC period and may instead reflect virus evolution over the course of the pandemic.
Collapse
Affiliation(s)
- Yanshan Zhu
- School of Chemistry and Molecular Biosciences, The University of Queensland, Brisbane, Australia
- Wesfarmer's Centre for Vaccines and Infectious Diseases, Telethon Kids Institute, University of Western Australia, Nedlands, Perth, Australia
- These authors contributed equally to this manuscript
| | - Yao Xia
- Department of Microbiology, State Key Laboratory of Emerging Infectious Diseases, Carol Yu Centre for Infection, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong Special Administrative Region, China
- These authors contributed equally to this manuscript
| | - Janessa Pickering
- Wesfarmer's Centre for Vaccines and Infectious Diseases, Telethon Kids Institute, University of Western Australia, Nedlands, Perth, Australia
| | - Asha C Bowen
- Wesfarmer's Centre for Vaccines and Infectious Diseases, Telethon Kids Institute, University of Western Australia, Nedlands, Perth, Australia
- Department of Infectious Diseases, Perth Children's Hospital, Nedlands, Perth, Australia
| | - Kirsty R Short
- School of Chemistry and Molecular Biosciences, The University of Queensland, Brisbane, Australia
- Australian Infectious Diseases Research Centre, The University of Queensland, Brisbane, Australia
| |
Collapse
|
8
|
Sieber J, Schmidthaler K, Kopanja S, Weseslindtner L, Stiasny K, Götzinger F, Graf A, Krotka P, Hoz J, Schoof A, Dwivedi V, Frischer T, Szépfalusi Z. Limited role of children in transmission of SARS-CoV-2 virus in households-Immunological analysis of 26 familial clusters. Pediatr Allergy Immunol 2023; 34:e13913. [PMID: 36705043 PMCID: PMC10107319 DOI: 10.1111/pai.13913] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Revised: 11/23/2022] [Accepted: 01/03/2023] [Indexed: 01/28/2023]
Abstract
BACKGROUND The impact of children on the transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) remains uncertain. This study provides an insight into distinct patterns of SARS-CoV-2 household transmission in case of pediatric and adult index cases as well as age-dependent susceptibility to SARS-CoV-2 infection. METHODS Immune analysis, medical interviewing, and contact tracing of 26 families with confirmed SARS-CoV-2 infection cases have been conducted. Blood samples were analyzed serologically with the use of a SARS-CoV-2-specific IgG assay and virus neutralization test (VNT). Uni- and multivariable linear regression and mixed effect logistic regression models were used to describe potential risk factors for higher contagiousness and susceptibility to SARS-CoV-2 infection. RESULTS SARS-CoV-2 infection could be confirmed in 67 of 124 family members. Fourteen children and 11 adults could be defined as index cases in their households. Forty of 82 exposed family members were defined as secondarily infected. The mean secondary attack rate in households was 0.48 and was significantly higher in households with adult than with pediatric index cases (0.85 vs 0.19; p < 0.0001). The age (grouped into child and adult) of index case, severity of disease, and occurrence of lower respiratory symptoms in index cases were significantly associated with secondary transmission rates in households. Children seem to be equally susceptible to acquire a SARS-CoV-2 infection as adults, but they suffer milder courses of the disease or remain asymptomatic. CONCLUSION SARS-CoV-2 transmission from infected children to other household members occurred rarely in the first wave of the pandemic, despite close physical contact and the lack of hygienic measures.
Collapse
Affiliation(s)
- Justyna Sieber
- Division of Paediatric Pulmonology, Allergy and Endocrinology, Department of Paediatrics and Adolescent Medicine, Comprehensive Centre of Paediatrics, Medical University of Vienna, Vienna, Austria.,Department of Clinical Immunology, Wroclaw Medical University, Wroclaw, Poland
| | - Klara Schmidthaler
- Division of Paediatric Pulmonology, Allergy and Endocrinology, Department of Paediatrics and Adolescent Medicine, Comprehensive Centre of Paediatrics, Medical University of Vienna, Vienna, Austria
| | - Sonja Kopanja
- Division of Paediatric Pulmonology, Allergy and Endocrinology, Department of Paediatrics and Adolescent Medicine, Comprehensive Centre of Paediatrics, Medical University of Vienna, Vienna, Austria
| | | | - Karin Stiasny
- Center for Virology, Medical University of Vienna, Vienna, Austria
| | - Florian Götzinger
- Department of Paediatrics and Adolescent Medicine, Klinik Ottakring, Vienna, Austria
| | - Alexandra Graf
- Section for Medical Statistics, Center for Medical Statistics, Informatics and Intelligent Systems, Medical University of Vienna, Austria
| | - Pavla Krotka
- Section for Medical Statistics, Center for Medical Statistics, Informatics and Intelligent Systems, Medical University of Vienna, Austria
| | - Jakub Hoz
- Division of Paediatric Pulmonology, Allergy and Endocrinology, Department of Paediatrics and Adolescent Medicine, Comprehensive Centre of Paediatrics, Medical University of Vienna, Vienna, Austria
| | - Anja Schoof
- Division of Paediatric Pulmonology, Allergy and Endocrinology, Department of Paediatrics and Adolescent Medicine, Comprehensive Centre of Paediatrics, Medical University of Vienna, Vienna, Austria
| | - Varsha Dwivedi
- Division of Paediatric Pulmonology, Allergy and Endocrinology, Department of Paediatrics and Adolescent Medicine, Comprehensive Centre of Paediatrics, Medical University of Vienna, Vienna, Austria
| | | | - Zsolt Szépfalusi
- Division of Paediatric Pulmonology, Allergy and Endocrinology, Department of Paediatrics and Adolescent Medicine, Comprehensive Centre of Paediatrics, Medical University of Vienna, Vienna, Austria
| |
Collapse
|
9
|
Vaccinating Children against SARS-CoV-2: A Literature Review and Survey of International Experts to Assess Safety, Efficacy and Perceptions of Vaccine Use in Children. Vaccines (Basel) 2022; 11:vaccines11010078. [PMID: 36679923 PMCID: PMC9862079 DOI: 10.3390/vaccines11010078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2022] [Revised: 12/16/2022] [Accepted: 12/16/2022] [Indexed: 12/31/2022] Open
Abstract
Introduction: The balance of risks and benefits of COVID-19 vaccination in children is more complex than in adults with limited paediatric data resulting in no global consensus on whether all healthy children should be vaccinated. We sought to assess the safety, efficacy, and effectiveness of childhood vaccination against SARS-CoV-2, as well as better understanding perceptions of vaccination in parents and vaccine experts. Methods: We performed a literature review for COVID-19 vaccine safety, efficacy, effectiveness, and perceptions. We searched international safety databases for safety data and developed an electronic survey to elicit country-specific COVID-19 immunisation data, including vaccine regulations, policies, rates, and public attitudes solicited from vaccine experts. Results: Nine studies were included in the final safety analysis. Local reactions were frequently reported across all studies and vaccine types. Adverse events reported to surveillance systems tended to be non-serious, and commonly included injection site reactions and dizziness. Twenty-three studies reported immunogenicity, efficacy, and effectiveness data. There were nine randomised control trials of six different vaccine types, which showed seroconversion of neutralising antibodies in vaccinated children ranging from 88% to 100%. The vaccine efficacy for Pfizer and Moderna vaccines ranged from 88% to 100%. There were 118 survey responses representing 55 different countries. Reported vaccination rates ranged from <1% to 98%. Most respondents described “mixed opinions” regarding paediatric vaccination policies in their country. By region, a more positive public attitude towards vaccination correlated with higher vaccination rates. Discussion: In this mixed-methods review, we have found evidence that vaccination against COVID-19 in children is safe, efficacious, and effective. Overall, the combined evidence from both the literature review and survey highlights the need for further data on both the safety and effectiveness of COVID-19 vaccinations in children.
Collapse
|
10
|
Goswami GG, Labib T. Modeling COVID-19 Transmission Dynamics: A Bibliometric Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:14143. [PMID: 36361019 PMCID: PMC9655715 DOI: 10.3390/ijerph192114143] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Revised: 10/15/2022] [Accepted: 10/26/2022] [Indexed: 06/16/2023]
Abstract
A good amount of research has evolved just in three years in COVID-19 transmission, mortality, vaccination, and some socioeconomic studies. A few bibliometric reviews have already been performed in the literature, especially on the broad theme of COVID-19, without any particular area such as transmission, mortality, or vaccination. This paper fills this gap by conducting a bibliometric review on COVID-19 transmission as the first of its kind. The main aim of this study is to conduct a bibliometric review of the literature in the area of COVID-19 transmission dynamics. We have conducted bibliometric analysis using descriptive and network analysis methods to review the literature in this area using RStudio, Openrefine, VOSviewer, and Tableau. We reviewed 1103 articles published in 2020-2022. The result identified the top authors, top disciplines, research patterns, and hotspots and gave us clear directions for classifying research topics in this area. New research areas are rapidly emerging in this area, which needs constant observation by researchers to combat this global epidemic.
Collapse
|
11
|
Nash D, Qasmieh S, Robertson M, Rane M, Zimba R, Kulkarni SG, Berry A, You W, Mirzayi C, Westmoreland D, Parcesepe A, Waldron L, Kochhar S, Maroko AR, Grov C. Household factors and the risk of severe COVID-like illness early in the U.S. pandemic. PLoS One 2022; 17:e0271786. [PMID: 35862418 PMCID: PMC9302833 DOI: 10.1371/journal.pone.0271786] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Accepted: 07/07/2022] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVE To investigate the role of children in the home and household crowding as risk factors for severe COVID-19 disease. METHODS We used interview data from 6,831 U.S. adults screened for the Communities, Households and SARS/CoV-2 Epidemiology (CHASING) COVID Cohort Study in April 2020. RESULTS In logistic regression models, the adjusted odds ratio [aOR] of hospitalization due to COVID-19 for having (versus not having) children in the home was 10.5 (95% CI:5.7-19.1) among study participants living in multi-unit dwellings and 2.2 (95% CI:1.2-6.5) among those living in single unit dwellings. Among participants living in multi-unit dwellings, the aOR for COVID-19 hospitalization among participants with more than 4 persons in their household (versus 1 person) was 2.5 (95% CI:1.0-6.1), and 0.8 (95% CI:0.15-4.1) among those living in single unit dwellings. CONCLUSION Early in the US SARS-CoV-2 pandemic, certain household exposures likely increased the risk of both SARS-CoV-2 acquisition and the risk of severe COVID-19 disease.
Collapse
Affiliation(s)
- Denis Nash
- Institute for Implementation Science in Population Health (ISPH), City University of New York (CUNY), New York City, New York, United States of America
- Department of Epidemiology and Biostatistics, Graduate School of Public Health and Health Policy, City University of New York (CUNY), New York City, New York, United States of America
| | - Saba Qasmieh
- Institute for Implementation Science in Population Health (ISPH), City University of New York (CUNY), New York City, New York, United States of America
- Department of Epidemiology and Biostatistics, Graduate School of Public Health and Health Policy, City University of New York (CUNY), New York City, New York, United States of America
| | - McKaylee Robertson
- Institute for Implementation Science in Population Health (ISPH), City University of New York (CUNY), New York City, New York, United States of America
- Department of Epidemiology and Biostatistics, Graduate School of Public Health and Health Policy, City University of New York (CUNY), New York City, New York, United States of America
| | - Madhura Rane
- Institute for Implementation Science in Population Health (ISPH), City University of New York (CUNY), New York City, New York, United States of America
| | - Rebecca Zimba
- Institute for Implementation Science in Population Health (ISPH), City University of New York (CUNY), New York City, New York, United States of America
- Department of Epidemiology and Biostatistics, Graduate School of Public Health and Health Policy, City University of New York (CUNY), New York City, New York, United States of America
| | - Sarah G. Kulkarni
- Institute for Implementation Science in Population Health (ISPH), City University of New York (CUNY), New York City, New York, United States of America
| | - Amanda Berry
- Institute for Implementation Science in Population Health (ISPH), City University of New York (CUNY), New York City, New York, United States of America
| | - William You
- Institute for Implementation Science in Population Health (ISPH), City University of New York (CUNY), New York City, New York, United States of America
| | - Chloe Mirzayi
- Institute for Implementation Science in Population Health (ISPH), City University of New York (CUNY), New York City, New York, United States of America
- Department of Epidemiology and Biostatistics, Graduate School of Public Health and Health Policy, City University of New York (CUNY), New York City, New York, United States of America
| | - Drew Westmoreland
- Institute for Implementation Science in Population Health (ISPH), City University of New York (CUNY), New York City, New York, United States of America
| | - Angela Parcesepe
- Department of Maternal and Child Health, Gillings School of Public Health, University of North Carolina, Chapel Hill, North Carolina, United States of America
- Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
| | - Levi Waldron
- Institute for Implementation Science in Population Health (ISPH), City University of New York (CUNY), New York City, New York, United States of America
- Department of Environmental, Occupational, and Geospatial Health Sciences, Graduate School of Public Health and Health Policy, City University of New York (CUNY), New York City, New York, United States of America
| | - Shivani Kochhar
- Institute for Implementation Science in Population Health (ISPH), City University of New York (CUNY), New York City, New York, United States of America
| | - Andrew R. Maroko
- Institute for Implementation Science in Population Health (ISPH), City University of New York (CUNY), New York City, New York, United States of America
- Department of Environmental, Occupational, and Geospatial Health Sciences, Graduate School of Public Health and Health Policy, City University of New York (CUNY), New York City, New York, United States of America
| | - Christian Grov
- Institute for Implementation Science in Population Health (ISPH), City University of New York (CUNY), New York City, New York, United States of America
- Department of Community Health and Social Sciences, Graduate School of Public Health and Health Policy, City University of New York (CUNY), New York City, New York, United States of America
| | | |
Collapse
|
12
|
Congrave-Wilson Z, Cheng WA, Lee Y, Perez S, Turner L, Marentes Ruiz CJ, Mendieta S, Skura A, Jumarang J, Del Valle J, Kubale J, Allen EK, Thomas PG, Gordon A, Pannaraj PS. Twelve-Month Longitudinal Serology in SARS-CoV-2 Naïve and Experienced Vaccine Recipients and Unvaccinated COVID-19-Infected Individuals. Vaccines (Basel) 2022; 10:813. [PMID: 35632569 PMCID: PMC9143304 DOI: 10.3390/vaccines10050813] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Revised: 05/16/2022] [Accepted: 05/17/2022] [Indexed: 11/16/2022] Open
Abstract
Longitudinal data comparing SARS-CoV-2 serology in individuals following infection and vaccination over 12 months are limited. This study compared the magnitude, decay, and variability in serum IgG, IgA, and neutralizing activity induced by natural infection (n = 218) or mRNA vaccination in SARS-CoV-2 naïve (n = 143) or experienced (n = 122) individuals over time using enzyme-linked immunosorbent assays and an in vitro virus neutralization assay. Serological responses were found to be highly variable after natural infection compared with vaccination but durable through 12 months. Antibody levels in vaccinated, SARS-CoV-2 naïve individuals peaked by 1 month then declined through 9 months, culminating in non-detectable SARS-CoV-2-specific serum IgA. Individuals with both infection and vaccination showed SARS-CoV-2-specific IgG and IgA levels that were more robust and slower to decline than the other groups; neutralizing activity remained highest in this group at 9 months past vaccination. These data reinforce the benefit of vaccination after SARS-CoV-2 recovery.
Collapse
Affiliation(s)
- Zion Congrave-Wilson
- Division of Infectious Diseases, Children’s Hospital Los Angeles, Los Angeles, CA 90027, USA; (Z.C.-W.); (W.A.C.); (Y.L.); (S.P.); (L.T.); (C.J.M.R.); (S.M.); (A.S.); (J.J.); (J.D.V.)
| | - Wesley A. Cheng
- Division of Infectious Diseases, Children’s Hospital Los Angeles, Los Angeles, CA 90027, USA; (Z.C.-W.); (W.A.C.); (Y.L.); (S.P.); (L.T.); (C.J.M.R.); (S.M.); (A.S.); (J.J.); (J.D.V.)
| | - Yesun Lee
- Division of Infectious Diseases, Children’s Hospital Los Angeles, Los Angeles, CA 90027, USA; (Z.C.-W.); (W.A.C.); (Y.L.); (S.P.); (L.T.); (C.J.M.R.); (S.M.); (A.S.); (J.J.); (J.D.V.)
| | - Stephanie Perez
- Division of Infectious Diseases, Children’s Hospital Los Angeles, Los Angeles, CA 90027, USA; (Z.C.-W.); (W.A.C.); (Y.L.); (S.P.); (L.T.); (C.J.M.R.); (S.M.); (A.S.); (J.J.); (J.D.V.)
| | - Lauren Turner
- Division of Infectious Diseases, Children’s Hospital Los Angeles, Los Angeles, CA 90027, USA; (Z.C.-W.); (W.A.C.); (Y.L.); (S.P.); (L.T.); (C.J.M.R.); (S.M.); (A.S.); (J.J.); (J.D.V.)
| | - Carolyn Jennifer Marentes Ruiz
- Division of Infectious Diseases, Children’s Hospital Los Angeles, Los Angeles, CA 90027, USA; (Z.C.-W.); (W.A.C.); (Y.L.); (S.P.); (L.T.); (C.J.M.R.); (S.M.); (A.S.); (J.J.); (J.D.V.)
| | - Shirley Mendieta
- Division of Infectious Diseases, Children’s Hospital Los Angeles, Los Angeles, CA 90027, USA; (Z.C.-W.); (W.A.C.); (Y.L.); (S.P.); (L.T.); (C.J.M.R.); (S.M.); (A.S.); (J.J.); (J.D.V.)
| | - Adam Skura
- Division of Infectious Diseases, Children’s Hospital Los Angeles, Los Angeles, CA 90027, USA; (Z.C.-W.); (W.A.C.); (Y.L.); (S.P.); (L.T.); (C.J.M.R.); (S.M.); (A.S.); (J.J.); (J.D.V.)
| | - Jaycee Jumarang
- Division of Infectious Diseases, Children’s Hospital Los Angeles, Los Angeles, CA 90027, USA; (Z.C.-W.); (W.A.C.); (Y.L.); (S.P.); (L.T.); (C.J.M.R.); (S.M.); (A.S.); (J.J.); (J.D.V.)
| | - Jennifer Del Valle
- Division of Infectious Diseases, Children’s Hospital Los Angeles, Los Angeles, CA 90027, USA; (Z.C.-W.); (W.A.C.); (Y.L.); (S.P.); (L.T.); (C.J.M.R.); (S.M.); (A.S.); (J.J.); (J.D.V.)
| | - John Kubale
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI 48109, USA; (J.K.); (A.G.)
| | - Emma Kaitlynn Allen
- Department of Immunology, St. Jude Children’s Research Hospital, Memphis, TN 38105, USA; (E.K.A.); (P.G.T.)
| | - Paul G. Thomas
- Department of Immunology, St. Jude Children’s Research Hospital, Memphis, TN 38105, USA; (E.K.A.); (P.G.T.)
| | - Aubree Gordon
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI 48109, USA; (J.K.); (A.G.)
| | - Pia S. Pannaraj
- Division of Infectious Diseases, Children’s Hospital Los Angeles, Los Angeles, CA 90027, USA; (Z.C.-W.); (W.A.C.); (Y.L.); (S.P.); (L.T.); (C.J.M.R.); (S.M.); (A.S.); (J.J.); (J.D.V.)
- Department of Pediatrics and Molecular Microbiology and Immunology, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA
| |
Collapse
|
13
|
Karan A. We need more support and less normalcy to stop airborne viruses. BMJ 2022; 377:o976. [PMID: 35418446 DOI: 10.1136/bmj.o976] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
|
14
|
Madewell ZJ, Yang Y, Longini IM, Halloran ME, Dean NE. Household Secondary Attack Rates of SARS-CoV-2 by Variant and Vaccination Status: An Updated Systematic Review and Meta-analysis. JAMA Netw Open 2022; 5:e229317. [PMID: 35482308 PMCID: PMC9051991 DOI: 10.1001/jamanetworkopen.2022.9317] [Citation(s) in RCA: 105] [Impact Index Per Article: 52.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
IMPORTANCE An overall household secondary attack rate (SAR) of 18.9% (95% CI, 16.2%-22.0%) through June 17, 2021 was previously reported for SARS-CoV-2. Emerging variants of concern and increased vaccination have affected transmission rates. OBJECTIVE To evaluate how reported household SARs changed over time and whether SARs varied by viral variant and index case and contact vaccination status. DATA SOURCES PubMed and medRxiv from June 18, 2021, through March 8, 2022, and reference lists of eligible articles. Preprints were included. STUDY SELECTION Articles with original data reporting the number of infected and total number of household contacts. Search terms included SARS-CoV-2, COVID-19, variant, vaccination, secondary attack rate, secondary infection rate, household, index case, family contacts, close contacts, and family transmission. DATA EXTRACTION AND SYNTHESIS The Preferred Reporting Items for Systematic Reviews and Meta-Analyses reporting guideline was followed. Meta-analyses used generalized linear mixed models to obtain SAR estimates and 95% CIs. MAIN OUTCOMES AND MEASURES SAR stratified by covariates according to variant, index case and contact vaccination status, and index case identification period. SARs were used to estimate vaccine effectiveness on the basis of the transmission probability for susceptibility to infection (VES,p), infectiousness given infection (VEI,p), and total vaccine effectiveness (VET,p). RESULTS Household SARs were higher for 33 studies with midpoints in 2021 to 2022 (37.3%; 95% CI, 32.7% to 42.1%) compared with 63 studies with midpoints through April 2020 (15.5%; 95% CI, 13.2% to 18.2%). Household SARs were 42.7% (95% CI, 35.4% to 50.4%) for Omicron (7 studies), 36.4% (95% CI, 33.4% to 39.5%) for Alpha (11 studies), 29.7% (95% CI, 23.0% to 37.3%) for Delta (16 studies), and 22.5% (95% CI, 18.6% to 26.8%) for Beta (3 studies). For full vaccination, VES,p was 78.6% (95% CI, 76.0% to 80.9%) for Alpha, 56.4% (95% CI, 54.6% to 58.1%) for Delta, and 18.1% (95% CI, -18.3% to 43.3%) for Omicron; VEI,p was 75.3% (95% CI, 69.9% to 79.8%) for Alpha, 21.9% (95% CI, 11.0% to 31.5%) for Delta, and 18.2% (95% CI, 0.6% to 32.6%) for Omicron; and VET,p was 94.7% (95% CI, 93.3% to 95.8%) for Alpha, 64.4% (95% CI, 58.0% to 69.8%) for Delta, and 35.8% (95% CI, 13.0% to 52.6%) for Omicron. CONCLUSIONS AND RELEVANCE These results suggest that emerging SARS-CoV-2 variants of concern have increased transmissibility. Full vaccination was associated with reductions in susceptibility and infectiousness, but more so for Alpha than Delta and Omicron. The changes in estimated vaccine effectiveness underscore the challenges of developing effective vaccines concomitant with viral evolution.
Collapse
Affiliation(s)
| | - Yang Yang
- Department of Biostatistics, University of Florida, Gainesville
| | - Ira M. Longini
- Department of Biostatistics, University of Florida, Gainesville
| | - M. Elizabeth Halloran
- Fred Hutchinson Cancer Research Center, Seattle, Washington
- Department of Biostatistics, University of Washington, Seattle
| | - Natalie E. Dean
- Department of Biostatistics and Bioinformatics, Emory University, Atlanta, Georgia
| |
Collapse
|
15
|
Madewell ZJ, Yang Y, Longini IM, Halloran ME, Dean NE. Household secondary attack rates of SARS-CoV-2 by variant and vaccination status: an updated systematic review and meta-analysis. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2022:2022.01.09.22268984. [PMID: 35043125 PMCID: PMC8764734 DOI: 10.1101/2022.01.09.22268984] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
We previously reported a household secondary attack rate (SAR) for SARS-CoV-2 of 18.9% through June 17, 2021. To examine how emerging variants and increased vaccination have affected transmission rates, we searched PubMed from June 18, 2021, through January 7, 2022. Meta-analyses used generalized linear mixed models to obtain SAR estimates and 95%CI, disaggregated by several covariates. SARs were used to estimate vaccine effectiveness based on the transmission probability for susceptibility ( VE S,p ), infectiousness ( VE I,p ), and total vaccine effectiveness ( VE T,p ). Household SAR for 27 studies with midpoints in 2021 was 35.8% (95%CI, 30.6%-41.3%), compared to 15.7% (95%CI, 13.3%-18.4%) for 62 studies with midpoints through April 2020. Household SARs were 38.0% (95%CI, 36.0%-40.0%), 30.8% (95%CI, 23.5%-39.3%), and 22.5% (95%CI, 18.6%-26.8%) for Alpha, Delta, and Beta, respectively. VE I,p , VE S,p , and VE T,p were 56.6% (95%CI, 28.7%-73.6%), 70.3% (95%CI, 59.3%-78.4%), and 86.8% (95%CI, 76.7%-92.5%) for full vaccination, and 27.5% (95%CI, -6.4%-50.7%), 43.9% (95%CI, 21.8%-59.7%), and 59.9% (95%CI, 34.4%-75.5%) for partial vaccination, respectively. Household contacts exposed to Alpha or Delta are at increased risk of infection compared to the original wild-type strain. Vaccination reduced susceptibility to infection and transmission to others. SUMMARY Household secondary attack rates (SARs) were higher for Alpha and Delta variants than previous estimates. SARs were higher to unvaccinated contacts than to partially or fully vaccinated contacts and were higher from unvaccinated index cases than from fully vaccinated index cases.
Collapse
Affiliation(s)
| | - Yang Yang
- Department of Biostatistics, University of Florida, Gainesville, FL
| | - Ira M. Longini
- Department of Biostatistics, University of Florida, Gainesville, FL
| | - M. Elizabeth Halloran
- Fred Hutchinson Cancer Research Center, Seattle, WA
- Department of Biostatistics, University of Washington, Seattle, WA
| | - Natalie E. Dean
- Department of Biostatistics, University of Florida, Gainesville, FL
| |
Collapse
|