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Factors associated with SARS-CoV-2 infection in unvaccinated children and young adults
Sarah L Silverberg1,2, Hennady P Shulha1,3, Brynn McMillan1,4
1Vaccine Evaluation Center, BC Children's Hospital Research Institute, 950 West 28th Ave Vancouver, V5Z 4H4, Vancouver, BC, Canada.
Insights
SARS-CoV-2 seropositivity was low in unvaccinated children and young adults in British Columbia by May 2022. South Asian ethnicity was linked to higher infection rates, highlighting the need for better diagnostics.
Area of Science:
- Public Health
- Epidemiology
- Infectious Diseases
Background:
- Pediatric COVID-19 often presents as mild or asymptomatic, complicating disease burden estimation.
- Existing testing practices may underestimate the true prevalence of SARS-CoV-2 in younger populations.
- Understanding age-specific seropositivity is crucial for effective pandemic response.
Purpose of the Study:
- To determine age-specific population seropositivity for SARS-CoV-2 in children and young adults in British Columbia (BC).
- To identify risk factors associated with SARS-CoV-2 seropositivity in this demographic.
- To inform diagnostic and reporting strategies for future public health initiatives.
Main Methods:
- Two cross-sectional serosurveys were conducted in BC between November 2020 and May 2022.
- Participants aged under 25 years (Phase 1) and under 10 years (Phase 2) provided dried blood spot samples and completed electronic surveys.
- Samples were tested for immunoglobulin G antibodies against the SARS-CoV-2 spike protein (S), with multivariable analyses performed.
Main Results:
- Overall S-seropositivity was 4.4% in Phase 1 and 8.8% in unvaccinated children under 10 in Phase 2.
- South Asian participants showed significantly higher seropositivity (13.5%) compared to other ethnicities (5.2%).
- Young infants (7.0%) and young adults (7.2%) exhibited the highest seropositivity rates.
Conclusions:
- SARS-CoV-2 seropositivity remained low among unvaccinated children and young adults by May 2022.
- South Asian populations experienced a disproportionate burden of infection.
- The findings underscore the need for improved diagnostics and reporting that consider age-specific pandemic dynamics.
Background And Objectives:
Pediatric COVID-19 cases are often mild or asymptomatic, which has complicated estimations of disease burden using existing testing practices. We aimed to determine the age-specific population seropositivity and risk factors of SARS-CoV-2 seropositivity among children and young adults during the pandemic in British Columbia (BC).
Methods:
We conducted two cross-sectional serosurveys: phase 1 enrolled children and adults < 25 years between November 2020-May 2021 and phase 2 enrolled children < 10 years between June 2021-May 2022 in BC. Participants completed electronic surveys and self-collected finger-prick dried blood spot (DBS) samples. Samples were tested for immunoglobulin G antibodies against ancestral spike protein (S). Descriptive statistics from survey data were reported and two multivariable analyses were conducted to evaluate factors associated with seropositivity.
Results:
A total of 2864 participants were enrolled, of which 95/2167 (4.4%) participants were S-seropositive in phase 1 across all ages, and 61/697 (8.8%) unvaccinated children aged under ten years were S-seropositive in phase 2. Overall, South Asian participants had a higher seropositivity than other ethnicities (13.5% vs. 5.2%). Of 156 seropositive participants in both phases, 120 had no prior positive SARS-CoV-2 test. Young infants and young adults had the highest reported seropositivity rates (7.0% and 7.2% respectively vs. 3.0-5.6% across other age groups).
Conclusions:
SARS-CoV-2 seropositivity among unvaccinated children and young adults was low in May 2022, and South Asians were disproportionately infected. This work demonstrates the need for improved diagnostics and reporting strategies that account for age-specific differences in pandemic dynamics and acceptability of testing mechanisms.
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