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Identifying susceptibility of children and adolescents to the Omicron variant (B.1.1.529)
June Young Chun1, Hwichang Jeong2, Yongdai Kim3
1Department of Internal Medicine, National Cancer Center, Goyang, South Korea. june.y.chun@ncc.re.kr.
Insights
The Omicron variant (B.1.1.529) shows increased susceptibility in children compared to earlier SARS-CoV-2 strains. This age-varying susceptibility was observed even after accounting for vaccination and contact patterns.
Area of Science:
- Epidemiology
- Virology
- Public Health
Background:
- The Omicron variant (B.1.1.529) of SARS-CoV-2 is noted for increased transmissibility, particularly among children, potentially leading to conditions like croup.
- Higher COVID-19 case rates in children may be linked to increased social contact and vaccination strategies prioritizing older populations.
Purpose of the Study:
- To investigate and quantify age-specific susceptibility to the Omicron variant of SARS-CoV-2.
- To compare Omicron susceptibility across different age groups, considering pre-Omicron variants.
Main Methods:
- Development of an age-structured compartmental model incorporating South Korean contact matrices and epidemiological data.
- Utilizing Bayesian inference to estimate age-specific force of infection and susceptibility during distinct COVID-19 waves (pre-Delta, Delta, Omicron).
- Exclusion of vaccinated individuals from susceptible populations based on vaccine effectiveness against Delta and Omicron variants.
Main Results:
- A significant increase in age-specific susceptibility to Omicron was observed in younger age groups compared to pre-Omicron variants.
- The highest increase in susceptibility to Omicron/pre-Delta was noted in the 10-15 years age group (5.28 times).
- Susceptibility to Omicron/Delta rose most in the 15-19 years age group (3.21 times), while remaining around twofold in those over 50.
Conclusions:
- The Omicron variant of SARS-CoV-2 demonstrates a higher propensity to spread among children than previous strains.
- This increased pediatric susceptibility persists even after adjusting for contact patterns, vaccination status, and vaccine effectiveness.
- Findings highlight the need for age-specific public health strategies to mitigate Omicron transmission in children.
Background:
The Omicron variant (B.1.1.529) is estimated to be more transmissible than previous strains of SARS-CoV-2 especially among children, potentially resulting in croup which is a characteristic disease in children. Current coronavirus disease 2019 (COVID-19) cases among children might be higher because (i) school-aged children have higher contact rates and (ii) the COVID-19 vaccination strategy prioritizes the elderly in most countries. However, there have been no reports confirming the age-varying susceptibility to the Omicron variant to date.
Methods:
We developed an age-structured compartmental model, combining age-specific contact matrix in South Korea and observed distribution of periods between each stage of infection in the national epidemiological investigation. A Bayesian inference method was used to estimate the age-specific force of infection and, accordingly, age-specific susceptibility, given epidemic data during the third (pre-Delta), fourth (Delta driven), and fifth (Omicron driven) waves in South Korea. As vaccine uptake increased, individuals who were vaccinated were excluded from the susceptible population in accordance with vaccine effectiveness against the Delta and Omicron variants, respectively.
Results:
A significant difference between the age-specific susceptibility to the Omicron and that to the pre-Omicron variants was found in the younger age group. The rise in susceptibility to the Omicron/pre-Delta variant was highest in the 10-15 years age group (5.28 times [95% CI, 4.94-5.60]), and the rise in susceptibility to the Omicron/Delta variant was highest in the 15-19 years age group (3.21 times [95% CI, 3.12-3.31]), whereas in those aged 50 years or more, the susceptibility to the Omicron/pre-Omicron remained stable at approximately twofold.
Conclusions:
Even after adjusting for contact pattern, vaccination status, and waning of vaccine effectiveness, the Omicron variant of SARS-CoV-2 tends to propagate more easily among children than the pre-Omicron strains.
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