Children and adolescents' experiences of mandatory SARS-CoV-2 testing in schools: a cross-sectional survey

Public health measures during the COVID-19 pandemic had dramatic consequences for children and adolescents. However, policy-makers and healthcare researchers did not give sufficient weight to children's perspectives. One common public health measure was mandatory SARS-CoV-2 tests in schools. This study examines the evaluation of such mandatory testing.

We investigated the effects of test type (pooled PCR tests vs antigen rapid tests) and demographic and psychological factors on evaluations of the experience of being tested. A total of 569 children (8-17 years) in two major German cities completed online questionnaires between October and December 2021. Participants answered questions addressing test evaluation, vaccination status, pandemic-related stress, mental health difficulties and health-related quality of life.

Our results showed that overall test ratings were better for pooled PCR tests (p<0.001). Vaccine-willing students evaluated SARS-CoV-2 tests more positively than vaccine-unwilling students, regardless of test type (p<0.001). Children with mental health difficulties (abnormal/borderline Strength and Difficulties Questionnaire (SDQ) scores) evaluated SARS-CoV-2 tests more negatively than children with normal SDQ scores (p<0.001). Additionally, children who reported better health-related quality of life and children with less pandemic-related stress rated the tests more positively.

Our results suggest that there are differences in the appraisal of the test types and that specific subgroups' experiences of regular testing vary. Our study provides insights for policy-makers in future pandemics and raises questions regarding parallels between testing and vaccination hesitancy. Moreover, our study demonstrates the feasibility and value of collecting data directly from a large cohort of children in order to understand their experiences.