National and regional prevalence of SARS-CoV-2 antibodies in primary and secondary school children in England: the School Infection Survey, a national open cohort study, November 2021SARS-CoV-2 antibody prevalence in school children.
Creators: name: Powell, Annabel A
name: Ireland, Georgina
name: Leeson, Rebecca
name: Lacey, Andrea
name: Ford, Ben
name: Poh, John
name: Ijaz, Samreen
name: Shute, Justin
name: Cherepanov, Peter
name: Tedder, Richard
name: Bottomley, Christian
name: Dawe, Fiona
name: Mangtani, Punam
name: Jones, Peter
name: Nguipdop-Djomo, Patrick
name: Ladhani, Shamez N
name: Group, COVID-19 Schools Infection Survey
name: Ahmad, Shazaad
name: Baawuah, Frances
name: Beckmann, Joanne
name: Brent, Andrew
name: Brent, Bernadette
name: Garstang, Joanna
name: Okike, Ifeanyichukwu O
name: Brown, Kevin
name: Ramsay, Mary
name: Bonell, Chris
name: Cook, Sarah
name: Warren-Gash, Charlotte
name: Phelan, Jody
name: Hargreaves, James
name: Langan, Sinead
name: Sundaram, Neisha
name: McClenaghan, Elliot
name: McKay, Gillian
name: Edmunds, John
name: Fine, Paul
Publisher: name: The Francis Crick Institute
Year: 2023
Subjects: Biochemistry &amp; Proteomics
Genome Integrity &amp; Repair
Structural Biology &amp; Biophysics
Cell Cycle &amp; Chromosomes

description: BACKGROUND: SARS-CoV-2 infection rates are likely to be underestimated in children because of asymptomatic or mild infections. We aim to estimate national and regional prevalence of SARS-CoV-2 antibodies in primary (4-11-year-olds) and secondary (11-18-year-olds) school children between 10 November and 10 December 2021. METHODS: Cross-sectional surveillance in England using two stage sampling, firstly stratifying into regions and selecting local authorities, then selecting schools according to a stratified sample within selected local authorities. Participants were sampled using a novel oral fluid validated assay for SARS-CoV-2 spike and nucleocapsid IgG antibodies. RESULTS: 4,980 students from 117 state-funded schools (2,706 from 83 primary schools, 2,274 from 34 secondary schools) provided a valid sample. After weighting for age, sex and ethnicity, and adjusting for assay accuracy, the national prevalence of SARS-CoV-2 antibodies in primary school students, who were all unvaccinated, was 40.1% (95%CI; 37.3-43.0). Antibody prevalence increased with age (p&lt;0.001) and were higher in urban than rural schools (p=0.01). In secondary school students, the adjusted, weighted national prevalence of SARS-CoV-2 antibodies was 82.4% (95%CI; 79.5-85.1); including 71.5% (95%CI; 65.7-76.8) in unvaccinated and 97.5% (95%CI; 96.1-98.5) in vaccinated students. Antibody prevalence increased with age (p&lt;0.001), and was not significantly different in urban versus rural students (p=0.1). CONCLUSIONS: In November 2021, using a validated oral fluid assay, national SARS-CoV-2 seroprevalence was estimated to be 40.1% in primary school students and 82.4% in secondary school students. In unvaccinated children this was approximately three-fold higher than confirmed infections highlighting the importance of seroprevalence studies to estimate prior exposure. DATA AVAILABILITY: De-identified study data are available for access by accredited researchers in the ONS Secure Research Service (SRS) for accredited research purposes under part 5, chapter 5 of the Digital Economy Act 2017. For further information about accreditation, contact Research.support@ons.gov.uk or visit the SRS website.