1
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Chervo TC, Elkin EP, Nugent JR, Valice E, Amsden LB, Ergas IJ, Munneke JR, Flores M, Saelee GN, Hsiao CA, Schapiro JM, Quesenberry CP, Corley DA, Habel LA, Kushi LH, Skarbinski J. Relative contribution of COVID-19 vaccination and SARS-CoV-2 infection to population-level seroprevalence of SARS-CoV-2 spike antibodies in a large integrated health system. PLoS One 2024; 19:e0303303. [PMID: 38900738 PMCID: PMC11189213 DOI: 10.1371/journal.pone.0303303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2024] [Accepted: 04/23/2024] [Indexed: 06/22/2024] Open
Abstract
BACKGROUND Understanding the relative contributions of SARS-CoV-2 infection-induced and vaccine-induced seroprevalence is key to measuring overall population-level seroprevalence and help guide policy decisions. METHODS Using a series of six population-based cross-sectional surveys conducted among persons aged ≥7 years in a large health system with over 4.5 million members between May 2021 and April 2022, we combined data from the electronic health record (EHR), an electronic survey and SARS-CoV-2 spike antibody binding assay, to assess the relative contributions of infection and vaccination to population-level SARS-CoV-2 seroprevalence. EHR and survey data were incorporated to determine spike antibody positivity due to SARS-CoV-2 infection and COVID-19 vaccination. We used sampling and non-response weighting to create population-level estimates. RESULTS We enrolled 4,319 persons over six recruitment waves. SARS-CoV-2 spike antibody seroprevalence increased from 83.3% (CI 77.0-88.9) in May 2021 to 93.5% (CI 89.5-97.5) in April 2022. By April 2022, 68.5% (CI 61.9-74.3) of the population was seropositive from COVID-19 vaccination only, 13.9% (10.7-17.9) from COVID-19 vaccination and prior diagnosed SARS-CoV-2 infection, 8.2% (CI 4.5-14.5) from prior diagnosed SARS-CoV-2 infection only and 2.9% (CI 1.1-7.6) from prior undiagnosed SARS-CoV-2 infection only. We found high agreement (≥97%) between EHR and survey data for ascertaining COVID-19 vaccination and SARS-CoV-2 infection status. CONCLUSIONS By April 2022, 93.5% of persons had detectable SARS-CoV-2 spike antibody, predominantly from COVID-19 vaccination. In this highly vaccinated population and over 18 months into the pandemic, SARS-CoV-2 infection without COVID-19 vaccination was a small contributor to overall population-level seroprevalence.
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Affiliation(s)
- Tyler C. Chervo
- Division of Research, Kaiser Permanente Northern California, Oakland, California, United States of America
| | - Eric P. Elkin
- Division of Research, Kaiser Permanente Northern California, Oakland, California, United States of America
| | - Joshua R. Nugent
- Division of Research, Kaiser Permanente Northern California, Oakland, California, United States of America
| | - Emily Valice
- Division of Research, Kaiser Permanente Northern California, Oakland, California, United States of America
| | - Laura B. Amsden
- Division of Research, Kaiser Permanente Northern California, Oakland, California, United States of America
| | - Isaac J. Ergas
- Division of Research, Kaiser Permanente Northern California, Oakland, California, United States of America
| | - Julie R. Munneke
- Division of Research, Kaiser Permanente Northern California, Oakland, California, United States of America
| | - Monica Flores
- Division of Research, Kaiser Permanente Northern California, Oakland, California, United States of America
| | - Gina N. Saelee
- Division of Research, Kaiser Permanente Northern California, Oakland, California, United States of America
| | - Crystal A. Hsiao
- Division of Research, Kaiser Permanente Northern California, Oakland, California, United States of America
| | - Jeffery M. Schapiro
- The Permanente Medical Group, Kaiser Permanente Northern California, Oakland, California, United States of America
| | - Charles P. Quesenberry
- Division of Research, Kaiser Permanente Northern California, Oakland, California, United States of America
| | - Douglas A. Corley
- Division of Research, Kaiser Permanente Northern California, Oakland, California, United States of America
- The Permanente Medical Group, Kaiser Permanente Northern California, Oakland, California, United States of America
| | - Laurel A. Habel
- Division of Research, Kaiser Permanente Northern California, Oakland, California, United States of America
| | - Lawrence H. Kushi
- Division of Research, Kaiser Permanente Northern California, Oakland, California, United States of America
| | - Jacek Skarbinski
- Division of Research, Kaiser Permanente Northern California, Oakland, California, United States of America
- The Permanente Medical Group, Kaiser Permanente Northern California, Oakland, California, United States of America
- Department of Infectious Diseases, Oakland Medical Center, Kaiser Permanente Northern California, Oakland, California, United States of America
- Physician Researcher Program, Kaiser Permanente Northern California, Oakland, California, United States of America
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2
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Kadelka S, Bouman JA, Ashcroft P, Regoes RR. Correcting for Antibody Waning in Cumulative Incidence Estimation From Sequential Serosurveys. Am J Epidemiol 2024; 193:777-786. [PMID: 38012125 PMCID: PMC11074712 DOI: 10.1093/aje/kwad226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Revised: 08/31/2023] [Accepted: 11/14/2023] [Indexed: 11/29/2023] Open
Abstract
Serosurveys are a widely used tool to estimate the cumulative incidence-the fraction of a population that has been infected by a given pathogen. These surveys rely on serological assays that measure the level of pathogen-specific antibodies. Because antibody levels are waning, the fraction of previously infected individuals that have seroreverted increases with time past infection. To avoid underestimating the true cumulative incidence, it is therefore essential to correct for waning antibody levels. We present an empirically supported approach for seroreversion correction in cumulative incidence estimation when sequential serosurveys are conducted in the context of a newly emerging infectious disease. The correction is based on the observed dynamics of antibody titers in seropositive cases and validated using several in silico test scenarios. Furthermore, through this approach we revise a previous cumulative incidence estimate relying on the assumption of an exponentially declining probability of seroreversion over time, of severe acute respiratory syndrome coronavirus 2, of 76% in Manaus, Brazil, by October 2020 to 47.6% (95% confidence region: 43.5-53.5). This estimate has implications, for example, for the proximity to herd immunity in Manaus in late 2020.
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Affiliation(s)
- Sarah Kadelka
- Correspondence to Dr. Sarah Kadelka, ETH Zürich, Institut für Integrative Biologie, CHN K 12.2, Universitätstrasse 16, 8092 Zürich, Switzerland (e-mail: ); or Prof. Dr. Roland R. Regoes, ETH Zürich, Institut für Integrative Biologie, CHN K 12.2, Universitätstrasse 16, 8092 Zürich, Switzerland (e-mail: )
| | | | | | - Roland R Regoes
- Correspondence to Dr. Sarah Kadelka, ETH Zürich, Institut für Integrative Biologie, CHN K 12.2, Universitätstrasse 16, 8092 Zürich, Switzerland (e-mail: ); or Prof. Dr. Roland R. Regoes, ETH Zürich, Institut für Integrative Biologie, CHN K 12.2, Universitätstrasse 16, 8092 Zürich, Switzerland (e-mail: )
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3
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Chervo TC, Elkin EP, Nugent JR, Valice E, Amsden LB, Ergas IJ, Munneke JR, Flores M, Saelee GN, Hsiao CA, Schapiro JM, Quesenberry CP, Corley DA, Habel LA, Kushi LH, Skarbinski J. Relative contribution of COVID-19 vaccination and SARS-CoV-2 infection to population-level seroprevalence of SARS-CoV-2 spike antibodies in a large integrated health system. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2024:2024.01.31.24301674. [PMID: 38352327 PMCID: PMC10863028 DOI: 10.1101/2024.01.31.24301674] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/02/2024]
Abstract
Background Understanding the relative contributions of SARS-CoV-2 infection-induced and vaccine- induced seroprevalence is key to measuring overall population-level seroprevalence and help guide policy decisions. Methods Using a series of six population-based cross-sectional surveys conducted among persons aged ≥7 years in a large health system with over 4.5 million members between May 2021 and April 2022, we combined data from the electronic health record (EHR), an electronic survey and SARS-CoV-2 spike antibody binding assay, to assess the relative contributions of infection and vaccination to population- level SARS-CoV-2 seroprevalence. EHR and survey data were incorporated to determine spike antibody positivity due to SARS-CoV-2 infection and COVID-19 vaccination. We used sampling and non-response weighting to create population-level estimates. Results We enrolled 4,319 persons over six recruitment waves. SARS-CoV-2 spike antibody seroprevalence increased from 83.3% (CI 77.0-88.9) in May 2021 to 93.5% (CI 89.5-97.5) in April 2022. By April 2022, 68.5% (CI 61.9-74.3) of the population was seropositive from COVID-19 vaccination only, 13.9% (10.7-17.9) from COVID-19 vaccination and prior diagnosed SARS-CoV-2 infection, 8.2% (CI 4.5- 14.5) from prior diagnosed SARS-CoV-2 infection only and 2.9% (CI 1.1-7.6) from prior undiagnosed SARS-CoV-2 infection only. We found high agreement (≥97%) between EHR and survey data for ascertaining COVID-19 vaccination and SARS-CoV-2 infection status. Conclusions By April 2022, 93.5% of persons had detectable SARS-CoV-2 spike antibody, predominantly from COVID-19 vaccination. In this highly vaccinated population and over 18 months into the pandemic, SARS-CoV-2 infection without COVID-19 vaccination was a small contributor to overall population-level seroprevalence. Article summary By April 2022, >93% of people had antibodies to SARS-CoV-2 with COVID-19 vaccination as the main driver of overall population-level seroprevalence in our healthcare system. SARS-CoV-2 infection without vaccination made a small contribution to population-level seroprevalence in our healthcare system.
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Choi HW, Achangwa C, Park J, Lee SM, Lee NY, Jeon CH, Choi JH, Do HK, Nam JH, Lee JW, Kim B, Ryu S, Kee SJ. Pediatric humoral immune responses and infection risk after severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and two-dose vaccination during SARS-CoV-2 omicron BA.5 and BN.1 variants predominance in South Korea. Front Immunol 2023; 14:1306604. [PMID: 38193075 PMCID: PMC10773891 DOI: 10.3389/fimmu.2023.1306604] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Accepted: 12/06/2023] [Indexed: 01/10/2024] Open
Abstract
Background Humoral immune responses and infection risk after severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and coronavirus disease 2019 (COVID-19) vaccination during the Omicron BA.5 and BN.1 variants predominant period remains unexplored in pediatric population. Methods We examined anti-spike (anti-S) immunoglobulin G (IgG) responses in a total of 986 children aged 4-18 years who visited outpatient clinics between June 2022 and January 2023, with a history of SARS-CoV-2 infection alone, completed two doses of COVID-19 vaccination alone, vaccine-breakthrough infection (i.e., infection after the single dose of vaccination), and no antigenic exposure. Furthermore, to determine SARS-CoV-2 infection risk, the incidence of newly developed SARS-CoV-2 infection was investigated up to March 2023. Results The anti-S IgG levels in the 'vaccine-breakthrough infection' group exceeded those in the 'infection alone' and 'vaccination alone' groups (both P <0.01). Furthermore, the 'vaccination alone' group experienced more rapid anti-S IgG waning than the 'infection alone' and 'vaccine-breakthrough infection' groups (both P <0.01). We could not identify newly developed SARS-CoV-2 infection in the 'vaccine-breakthrough infection' group. Conclusion Our findings suggest that hybrid immunity, acquired from SARS-CoV-2 infection and COVID-19 vaccination, was a potentially higher and longer-lasting humoral immune response and protected against SARS-CoV-2 infection in pediatric population during Omicron BA.5 and BN.1 variants predominant.
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Affiliation(s)
- Hyun-Woo Choi
- Department of Laboratory Medicine, Chonnam National University Hospital, Gwangju, Republic of Korea
| | - Chiara Achangwa
- Department of Preventive Medicine, Konyang University College of Medicine, Daejeon, Republic of Korea
| | - Joonhong Park
- Department of Laboratory Medicine, Jeonbuk National University Medical School and Hospital, Jeonju, Republic of Korea
| | - Sun Min Lee
- Department of Laboratory Medicine, Pusan National University School of Medicine, Pusan, Republic of Korea
| | - Nan Young Lee
- Department of Clinical Pathology, School of Medicine, Kyungpook National University, Daegu, Republic of Korea
| | - Chae-Hyeon Jeon
- Chonnam National University Research Institute of Medical Science, BioMedical Sciences Graduate Program (BMSGP), Chonnam National University Medical School, Hwasun, Republic of Korea
| | - Jeong-Hwa Choi
- Chonnam National University Research Institute of Medical Science, BioMedical Sciences Graduate Program (BMSGP), Chonnam National University Medical School, Hwasun, Republic of Korea
| | - Hyun Kyung Do
- Department of Preventive Medicine, Konyang University College of Medicine, Daejeon, Republic of Korea
| | - Jeong-Hyun Nam
- Division of Vaccine Clinical Research, Center for Vaccine Research, National Institute of Infectious Diseases, National Institute of Health, Korea Disease Control and Prevention Agency, Cheongju, Republic of Korea
| | - June-Woo Lee
- Division of Vaccine Clinical Research, Center for Vaccine Research, National Institute of Infectious Diseases, National Institute of Health, Korea Disease Control and Prevention Agency, Cheongju, Republic of Korea
| | - Byoungguk Kim
- Division of Vaccine Clinical Research, Center for Vaccine Research, National Institute of Infectious Diseases, National Institute of Health, Korea Disease Control and Prevention Agency, Cheongju, Republic of Korea
| | - Sukhyun Ryu
- Department of Preventive Medicine, Konyang University College of Medicine, Daejeon, Republic of Korea
| | - Seung-Jung Kee
- Department of Laboratory Medicine, Chonnam National University Hospital, Gwangju, Republic of Korea
- Chonnam National University Research Institute of Medical Science, BioMedical Sciences Graduate Program (BMSGP), Chonnam National University Medical School, Hwasun, Republic of Korea
- Department of Laboratory Medicine, Chonnam National University Medical School, Gwangju, Republic of Korea
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5
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García-Carreras B, Hitchings MDT, Johansson MA, Biggerstaff M, Slayton RB, Healy JM, Lessler J, Quandelacy T, Salje H, Huang AT, Cummings DAT. Accounting for assay performance when estimating the temporal dynamics in SARS-CoV-2 seroprevalence in the U.S. Nat Commun 2023; 14:2235. [PMID: 37076502 PMCID: PMC10115837 DOI: 10.1038/s41467-023-37944-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Accepted: 04/06/2023] [Indexed: 04/21/2023] Open
Abstract
Reconstructing the incidence of SARS-CoV-2 infection is central to understanding the state of the pandemic. Seroprevalence studies are often used to assess cumulative infections as they can identify asymptomatic infection. Since July 2020, commercial laboratories have conducted nationwide serosurveys for the U.S. CDC. They employed three assays, with different sensitivities and specificities, potentially introducing biases in seroprevalence estimates. Using models, we show that accounting for assays explains some of the observed state-to-state variation in seroprevalence, and when integrating case and death surveillance data, we show that when using the Abbott assay, estimates of proportions infected can differ substantially from seroprevalence estimates. We also found that states with higher proportions infected (before or after vaccination) had lower vaccination coverages, a pattern corroborated using a separate dataset. Finally, to understand vaccination rates relative to the increase in cases, we estimated the proportions of the population that received a vaccine prior to infection.
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Affiliation(s)
- Bernardo García-Carreras
- Department of Biology, University of Florida, Gainesville, FL, USA.
- Emerging Pathogens Institute, University of Florida, Gainesville, FL, USA.
| | - Matt D T Hitchings
- Department of Biostatistics, University of Florida, Gainesville, FL, USA
| | - Michael A Johansson
- COVID-19 Response, US Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Matthew Biggerstaff
- COVID-19 Response, US Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Rachel B Slayton
- COVID-19 Response, US Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Jessica M Healy
- COVID-19 Response, US Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Justin Lessler
- Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- UNC Carolina Population Center, Chapel Hill, NC, USA
| | | | - Henrik Salje
- Department of Genetics, University of Cambridge, Cambridge, UK
| | - Angkana T Huang
- Department of Genetics, University of Cambridge, Cambridge, UK
| | - Derek A T Cummings
- Department of Biology, University of Florida, Gainesville, FL, USA
- Emerging Pathogens Institute, University of Florida, Gainesville, FL, USA
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6
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Meza E, Cummings KJ, Vergara XP, Lai KW, Lim E, Lamba K, Kamali A, Bibbins-Domingo K, Jain S, Mehrotra ML. Evaluating the association between in-person work and the risk of SARS-CoV-2 infection through June 2021. Am J Ind Med 2023; 66:222-232. [PMID: 36645337 DOI: 10.1002/ajim.23458] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Revised: 12/09/2022] [Accepted: 12/27/2022] [Indexed: 01/17/2023]
Abstract
OBJECTIVES Recent studies have evaluated COVID-19 outbreaks and excess mortality by occupation sectors. Studies on SARS-CoV-2 infection across occupation and occupation-related factors remain lacking. In this study, we estimate the effect of in-person work on SARS-CoV-2 infection risk and describe SARS-CoV-2 seroprevalence among working adults. METHODS We used Wave 1 data (May to June 2021) from CalScope, a population-based seroprevalence study in California. Occupation data were coded using the National Institute for Occupational Safety and Health Industry and Occupation Computerized Coding System. Dried blood spot specimens were tested for antibodies to establish evidence of prior infection. We estimated the causal effect of in-person work on SARS-CoV-2 infection risk using the g-formula and describe SARS-CoV-2 seroprevalence across occupation-related factors. RESULTS Among 4335 working adults, 53% worked in person. In-person work was associated with increased risk of prior SARS-CoV-2 infection (risk difference: 0.03; [95% CI: 0.02-0.04]) compared with working remotely. Workers that reported job loss or who were without medical insurance had higher evidence of prior infection. Amongst in-person workers, evidence of prior infection was highest within farming, fishing, and forestry (55%; [95% CI: 26%-81%]); installation, maintenance, and repair (23%; [12%-39%]); building and grounds cleaning and maintenance (23%; [13%-36%]); food preparation and serving related (22% [13%-35%]); and healthcare support (22%; [13%-34%]) occupations. Workers who identified as Latino, reported a household income of <$25K, or who were without a bachelor's degree also had higher evidence of prior infection. CONCLUSIONS SARS-CoV-2 infection risk varies by occupation. Future vaccination strategies may consider prioritizing in-person workers.
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Affiliation(s)
- Erika Meza
- California Department of Public Health, Richmond, California, USA.,Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, California, USA
| | | | - Ximena P Vergara
- California Department of Public Health, Richmond, California, USA.,Heluna Health, City of Industry, California, USA
| | - Kristina W Lai
- California Department of Public Health, Richmond, California, USA
| | - Esther Lim
- California Department of Public Health, Richmond, California, USA
| | - Katherine Lamba
- California Department of Public Health, Richmond, California, USA
| | - Amanda Kamali
- California Department of Public Health, Richmond, California, USA
| | - Kirsten Bibbins-Domingo
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, California, USA
| | - Seema Jain
- California Department of Public Health, Richmond, California, USA
| | - Megha L Mehrotra
- California Department of Public Health, Richmond, California, USA
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7
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Darling AM, Shephard H, Nestoridi E, Manning SE, Yazdy MM. SARS-CoV-2 infection during pregnancy and preterm birth in Massachusetts from March 2020 through March 2021. Paediatr Perinat Epidemiol 2022; 37:93-103. [PMID: 36512318 PMCID: PMC9877646 DOI: 10.1111/ppe.12944] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Revised: 11/18/2022] [Accepted: 11/27/2022] [Indexed: 12/14/2022]
Abstract
BACKGROUND SARS-CoV-2 infection during pregnancy has been linked to preterm birth, but this association is not well understood. OBJECTIVES To examine the association between SARS-CoV-2 infection and spontaneous and provider-initiated preterm birth (PTB), and how timing of infection, and race/ethnicity as a marker of structural inequality, may modify this association. METHODS We conducted a retrospective cohort study among pregnant people who delivered singleton, liveborn infants (22-44 weeks gestation) from 1 March 2020 to 31 March 2021 (n = 68,288). We used Cox proportional hazards models to compare the hazard of PTB between pregnant people with and without laboratory-confirmed SARS-CoV-2 infection during pregnancy. We evaluated this association according to the trimester of infection, timing from infection to birth, and timing of PTB. We also examined the joint associations of SARS-CoV-2 infection and race/ethnicity with PTB using the relative excess risk due to interaction (RERI). RESULTS Positive SARS-CoV-2 tests were identified for 2195 pregnant people (3.2%). The prevalence of PTB was 7.2% (3.8% spontaneous, 3.6% provider-initiated). SARS-CoV-2 infection during pregnancy was associated with an increased risk of PTB overall (adjusted hazard ratio [HR] 1.53, 95% confidence interval [CI] 1.34, 1.74), and provider-initiated PTB (HR 1.79, 95% CI 1.50, 2.12) but not spontaneous PTB (HR 1.09, 95% CI 0.89, 1.36). Second trimester infections were associated with an increased risk of provider-initiated PTB, and third trimester infections were associated with an increased risk of both PTB subtypes. A joint inverse association between White non-Hispanic race/ethnicity and SARS-CoV-2 infection and spontaneous PTB (HR 0.56, 95% CI 0.34, 0.94; RERI -0.6, 95% CI -1.0, -0.2) was also observed. CONCLUSIONS SARS-CoV-2 infections were primarily associated with an increased risk for provider-initiated PTB in this study. These findings highlight the importance of promoting infection-prevention strategies among pregnant people.
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Affiliation(s)
- Anne Marie Darling
- Massachusetts Center for Birth Defects Research and Prevention, Bureau of Family Health and NutritionMassachusetts Department of Public HealthBostonMassachusettsUSA
| | - Hanna Shephard
- Massachusetts Center for Birth Defects Research and Prevention, Bureau of Family Health and NutritionMassachusetts Department of Public HealthBostonMassachusettsUSA,Council of State and Territorial Epidemiologists Applied Epidemiology FellowshipAtlantaGeorgiaUSA
| | - Eirini Nestoridi
- Massachusetts Center for Birth Defects Research and Prevention, Bureau of Family Health and NutritionMassachusetts Department of Public HealthBostonMassachusettsUSA
| | - Susan E. Manning
- Bureau of Family Health and NutritionMassachusetts Department of Public HealthBostonMassachusettsUSA,COVID‐19 ResponseCenters for Disease Control and PreventionAtlantaGeorgiaUSA
| | - Mahsa M. Yazdy
- Massachusetts Center for Birth Defects Research and Prevention, Bureau of Family Health and NutritionMassachusetts Department of Public HealthBostonMassachusettsUSA
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8
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Singal AG, Masica A, Esselink K, Murphy CC, Dever JA, Reczek A, Bensen M, Mack N, Stutts E, Ridenhour JL, Galt E, Brainerd J, Kopplin N, Yekkaluri S, Rubio C, Anderson S, Jan K, Whitworth N, Wagner J, Allen S, Muthukumar AR, Tiro J. Population-based correlates of COVID-19 infection: An analysis from the DFW COVID-19 prevalence study. PLoS One 2022; 17:e0278335. [PMID: 36454745 PMCID: PMC9714738 DOI: 10.1371/journal.pone.0278335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Accepted: 11/14/2022] [Indexed: 12/05/2022] Open
Abstract
BACKGROUND COVID-19 has resulted in over 1 million deaths in the U.S. as of June 2022, with continued surges after vaccine availability. Information on related attitudes and behaviors are needed to inform public health strategies. We aimed to estimate the prevalence of COVID-19, risk factors of infection, and related attitudes and behaviors in a racially, ethnically, and socioeconomically diverse urban population. METHODS The DFW COVID-19 Prevalence Study Protocol 1 was conducted from July 2020 to March 2021 on a randomly selected sample of adults aged 18-89 years, living in Dallas or Tarrant Counties, Texas. Participants were asked to complete a 15-minute questionnaire and COVID-19 PCR and antibody testing. COVID-19 prevalence estimates were calculated with survey-weighted data. RESULTS Of 2969 adults who completed the questionnaire (7.4% weighted response), 1772 (53.9% weighted) completed COVID-19 testing. Overall, 11.5% of adults had evidence of COVID-19 infection, with a higher prevalence among Hispanic and non-Hispanic Black persons, essential workers, those in low-income neighborhoods, and those with lower education attainment compared to their counterparts. We observed differences in attitudes and behaviors by race and ethnicity, with non-Hispanic White persons being less likely to believe in the importance of mask wearing, and racial and ethnic minorities more likely to attend social gatherings. CONCLUSION Over 10% of an urban population was infected with COVID-19 early during the pandemic. Differences in attitudes and behaviors likely contribute to sociodemographic disparities in COVID-19 prevalence.
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Affiliation(s)
- Amit G. Singal
- University of Texas Southwestern Medical Center, Dallas, Texas, United States of America
| | - Andrew Masica
- Texas Health Resources, Fort Worth, Texas, United States of America
| | - Kate Esselink
- University of Texas Southwestern Medical Center, Dallas, Texas, United States of America
| | - Caitlin C. Murphy
- University of Texas Southwestern Medical Center, Dallas, Texas, United States of America
| | - Jill A. Dever
- RTI International, Washington, District of Columbia, United States of America
| | - Annika Reczek
- University of Texas Southwestern Medical Center, Dallas, Texas, United States of America
| | - Matthew Bensen
- RTI International Headquarters, Research Triangle Park, North Carolina, United States of America
| | - Nicole Mack
- RTI International Headquarters, Research Triangle Park, North Carolina, United States of America
| | - Ellen Stutts
- RTI International Headquarters, Research Triangle Park, North Carolina, United States of America
| | - Jamie L. Ridenhour
- RTI International Headquarters, Research Triangle Park, North Carolina, United States of America
| | - Evan Galt
- University of Texas Southwestern Medical Center, Dallas, Texas, United States of America
| | - Jordan Brainerd
- University of Texas Southwestern Medical Center, Dallas, Texas, United States of America
| | - Noa Kopplin
- University of Texas Southwestern Medical Center, Dallas, Texas, United States of America
| | - Sruthi Yekkaluri
- University of Texas Southwestern Medical Center, Dallas, Texas, United States of America
| | - Chris Rubio
- University of Texas Southwestern Medical Center, Dallas, Texas, United States of America
| | - Shelby Anderson
- University of Texas Southwestern Medical Center, Dallas, Texas, United States of America
| | - Kathryn Jan
- University of Texas Southwestern Medical Center, Dallas, Texas, United States of America
| | | | | | - Stephen Allen
- Texas Health Resources, Fort Worth, Texas, United States of America
| | - Alagar R. Muthukumar
- University of Texas Southwestern Medical Center, Dallas, Texas, United States of America
| | - Jasmin Tiro
- University of Texas Southwestern Medical Center, Dallas, Texas, United States of America
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9
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Freedman ND, Brown L, Newman LM, Jones JM, Benoit TJ, Averhoff F, Bu X, Bayrak K, Lu A, Coffey B, Jackson L, Chanock SJ, Kerlavage AR. COVID-19 SeroHub, an online repository of SARS-CoV-2 seroprevalence studies in the United States. Sci Data 2022; 9:727. [DOI: 10.1038/s41597-022-01830-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Accepted: 11/09/2022] [Indexed: 11/28/2022] Open
Abstract
AbstractSeroprevalence studies provide useful information about the proportion of the population either vaccinated against SARS-CoV-2, previously infected with the virus, or both. Numerous studies have been conducted in the United States, but differ substantially by dates of enrollment, target population, geographic location, age distribution, and assays used. This can make it challenging to identify and synthesize available seroprevalence data by geographic region or to compare infection-induced versus combined infection- and vaccination-induced seroprevalence. To facilitate public access and understanding, the National Institutes of Health and the Centers for Disease Control and Prevention developed the COVID-19 Seroprevalence Studies Hub (COVID-19 SeroHub, https://covid19serohub.nih.gov/), a data repository in which seroprevalence studies are systematically identified, extracted using a standard format, and summarized through an interactive interface. Within COVID-19 SeroHub, users can explore and download data from 178 studies as of September 1, 2022. Tools allow users to filter results and visualize trends over time, geography, population, age, and antigen target. Because COVID-19 remains an ongoing pandemic, we will continue to identify and include future studies.
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10
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Strasser ZH, Greifer N, Hadavand A, Murphy SN, Estiri H. Estimates of SARS-CoV-2 Omicron BA.2 Subvariant Severity in New England. JAMA Netw Open 2022; 5:e2238354. [PMID: 36282501 PMCID: PMC9597387 DOI: 10.1001/jamanetworkopen.2022.38354] [Citation(s) in RCA: 43] [Impact Index Per Article: 21.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
IMPORTANCE The SARS-CoV-2 Omicron subvariant, BA.2, may be less severe than previous variants; however, confounding factors make interpreting the intrinsic severity challenging. OBJECTIVE To compare the adjusted risks of mortality, hospitalization, intensive care unit admission, and invasive ventilation between the BA.2 subvariant and the Omicron and Delta variants, after accounting for multiple confounders. DESIGN, SETTING, AND PARTICIPANTS This was a retrospective cohort study that applied an entropy balancing approach. Patients in a multicenter inpatient and outpatient system in New England with COVID-19 between March 3, 2020, and June 20, 2022, were identified. EXPOSURES Cases were assigned as being exposed to the Delta (B.1.617.2) variant, the Omicron (B.1.1.529) variant, or the Omicron BA.2 lineage subvariants. MAIN OUTCOMES AND MEASURES The primary study outcome planned before analysis was risk of 30-day mortality. Secondary outcomes included the risks of hospitalization, invasive ventilation, and intensive care unit admissions. RESULTS Of 102 315 confirmed COVID-19 cases (mean [SD] age, 44.2 [21.6] years; 63 482 women [62.0%]), 20 770 were labeled as Delta variants, 52 605 were labeled as the Omicron B.1.1.529 variant, and 28 940 were labeled as Omicron BA.2 subvariants. Patient cases were excluded if they occurred outside the prespecified temporal windows associated with the variants or had minimal longitudinal data in the Mass General Brigham system before COVID-19. Mortality rates were 0.7% for Delta (B.1.617.2), 0.4% for Omicron (B.1.1.529), and 0.3% for Omicron (BA.2). The adjusted odds ratio of mortality from the Delta variant compared with the Omicron BA.2 subvariants was 2.07 (95% CI, 1.04-4.10) and that of the original Omicron variant compared with the Omicron BA.2 subvariant was 2.20 (95% CI, 1.56-3.11). For all outcomes, the Omicron BA.2 subvariants were significantly less severe than that of the Omicron and Delta variants. CONCLUSIONS AND RELEVANCE In this cohort study, after having accounted for a variety of confounding factors associated with SARS-CoV-2 outcomes, the Omicron BA.2 subvariant was found to be intrinsically less severe than both the Delta and Omicron variants. With respect to these variants, the severity profile of SARS-CoV-2 appears to be diminishing after taking into account various factors including therapeutics, vaccinations, and prior infections.
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Affiliation(s)
- Zachary H. Strasser
- MGH Laboratory of Computer Science, Massachusetts General Hospital, Boston
- Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Noah Greifer
- Institute for Quantitative Social Science, Harvard University, Cambridge, Massachusetts
| | - Aboozar Hadavand
- College of Computational Science, Minerva University, San Francisco, California
| | - Shawn N. Murphy
- MGH Laboratory of Computer Science, Massachusetts General Hospital, Boston
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston
| | - Hossein Estiri
- MGH Laboratory of Computer Science, Massachusetts General Hospital, Boston
- Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
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11
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Balck A, Föh B, Borsche M, Rahmöller J, Vollstedt EJ, Waldeck F, Käding N, Twesten C, Mischnik A, Gillessen-Kaesbach G, Ehlers M, Sina C, Taube S, Busch H, Rupp J, Katalinic A, Klein C. Protocol of the Luebeck longitudinal investigation of SARS-CoV-2 infection (ELISA) study - a prospective population-based cohort study. BMC Public Health 2022; 22:1305. [PMID: 35799167 PMCID: PMC9261226 DOI: 10.1186/s12889-022-13666-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Accepted: 06/03/2022] [Indexed: 11/23/2022] Open
Abstract
Background Considering the insufficiently controlled spread of new SARS-CoV-2 variants, partially low vaccination rates, and increased risk of a post-COVID syndrome, well-functioning, targeted intervention measures at local and national levels are urgently needed to contain the SARS-CoV-2 pandemic. Surveillance concepts (cross-sectional, cohorts, clusters) need to be carefully selected to monitor and assess incidence and prevalence at the population level. A critical methodological gap for identifying specific risks/dynamics for SARS-Cov-2 transmission and post-COVID-19-syndrome includes repetitive testing for past or present infection of a defined cohort with simultaneous assessment of symptoms, behavior, risk, and protective factors, as well as quality of life. Methods The ELISA-Study is a longitudinal, prospective surveillance study with a cohort approach launched in Luebeck in April 2020. The first part comprised regular PCR testing, antibody measurements, and a recurrent App-based questionnaire for a population-based cohort of 3000 inhabitants of Luebeck. The follow-up study protocol includes self-testing for antibodies and PCR testing for a subset of the participants, focusing on studying immunity after vaccination and/or infection and post-COVID-19 symptoms. Discussion The ELISA cohort and our follow-up study protocol will enable us to study the effects of a sharp increase of SARS-CoV-2 infections on seroprevalence of Anti-SARS-CoV-2 antibodies, post-COVID-19-symptoms, and possible medical, occupational, and behavioral risk factors. We will be able to monitor the pandemic continuously and discover potential sequelae of an infection long-term. Further examinations can be readily set up on an ad-hoc basis in the future. Our study protocol can be adapted to other regions and settings and is transferable to other infectious diseases. Trial registration DRKS.de, German Clinical Trials Register (DRKS), Identifier: DRKS00023418, Registered on 28 October 2020. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-022-13666-z.
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Affiliation(s)
- Alexander Balck
- Institute of Neurogenetics, University of Lübeck and University Hospital Schleswig-Holstein, Lübeck, Germany.,Department of Neurology, University of Lübeck and University Hospital Schleswig-Holstein, Lübeck, Germany
| | - Bandik Föh
- Institute of Nutritional Medicine, University of Lübeck, Lübeck, Germany.,Department of Medicine I, University Hospital Schleswig-Holstein, Lübeck, Germany
| | - Max Borsche
- Institute of Neurogenetics, University of Lübeck and University Hospital Schleswig-Holstein, Lübeck, Germany.,Department of Neurology, University of Lübeck and University Hospital Schleswig-Holstein, Lübeck, Germany
| | - Johann Rahmöller
- Institute of Nutritional Medicine, University of Lübeck, Lübeck, Germany.,Department of Anesthesiology and Intensive Care, University of Lübeck and University Hospital Schleswig-Holstein, Lübeck, Germany
| | - Eva-Juliane Vollstedt
- Institute of Neurogenetics, University of Lübeck and University Hospital Schleswig-Holstein, Lübeck, Germany
| | - Frederike Waldeck
- Department of Infectious Diseases and Microbiology, University of Lübeck and University Hospital Schleswig-Holstein, Campus Lübeck, Lübeck, Germany
| | - Nadja Käding
- Department of Infectious Diseases and Microbiology, University of Lübeck and University Hospital Schleswig-Holstein, Campus Lübeck, Lübeck, Germany
| | | | | | | | - Marc Ehlers
- Institute of Nutritional Medicine, University of Lübeck, Lübeck, Germany
| | - Christian Sina
- Institute of Nutritional Medicine, University of Lübeck, Lübeck, Germany
| | - Stefan Taube
- Institute of Virology and Cell Biology, University of Lübeck, Lübeck, Germany
| | - Hauke Busch
- Lübeck Institute of Experimental Dermatology (LIED), University of Lübeck, Lübeck, Germany
| | - Jan Rupp
- Department of Infectious Diseases and Microbiology, University of Lübeck and University Hospital Schleswig-Holstein, Campus Lübeck, Lübeck, Germany
| | - Alexander Katalinic
- Institute of Social Medicine and Epidemiology, University of Lübeck, Lübeck, Germany
| | - Christine Klein
- Institute of Neurogenetics, University of Lübeck and University Hospital Schleswig-Holstein, Lübeck, Germany.
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12
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Nelson KN, Siegler AJ, Sullivan PS, Bradley H, Hall E, Luisi N, Hipp-Ramsey P, Sanchez T, Shioda K, Lopman BA. Nationally representative social contact patterns among U.S. adults, August 2020-April 2021. Epidemics 2022; 40:100605. [PMID: 35810698 PMCID: PMC9242729 DOI: 10.1016/j.epidem.2022.100605] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Revised: 06/14/2022] [Accepted: 06/27/2022] [Indexed: 11/25/2022] Open
Abstract
The response to the COVID-19 pandemic in the U.S prompted abrupt and dramatic changes to social contact patterns. Monitoring changing social behavior is essential to provide reliable input data for mechanistic models of infectious disease, which have been increasingly used to support public health policy to mitigate the impacts of the pandemic. While some studies have reported on changing contact patterns throughout the pandemic, few have reported differences in contact patterns among key demographic groups and none have reported nationally representative estimates. We conducted a national probability survey of US households and collected information on social contact patterns during two time periods: August-December 2020 (before widespread vaccine availability) and March-April 2021 (during national vaccine rollout). Overall, contact rates in Spring 2021 were similar to those in Fall 2020, with most contacts reported at work. Persons identifying as non-White, non-Black, non-Asian, and non-Hispanic reported high numbers of contacts relative to other racial and ethnic groups. Contact rates were highest in those reporting occupations in retail, hospitality and food service, and transportation. Those testing positive for SARS-CoV-2 antibodies reported a higher number of daily contacts than those who were seronegative. Our findings provide evidence for differences in social behavior among demographic groups, highlighting the profound disparities that have become the hallmark of the COVID-19 pandemic.
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Affiliation(s)
- Kristin N Nelson
- Department of Epidemiology, Rollins School of Public Health, Emory University, USA.
| | - Aaron J Siegler
- Department of Epidemiology, Rollins School of Public Health, Emory University, USA
| | - Patrick S Sullivan
- Department of Epidemiology, Rollins School of Public Health, Emory University, USA
| | - Heather Bradley
- Department of Population Health Sciences, Georgia State University School of Public Health, USA
| | - Eric Hall
- School of Public Health, Oregon Health & Science University, USA
| | - Nicole Luisi
- Department of Epidemiology, Rollins School of Public Health, Emory University, USA
| | - Palmer Hipp-Ramsey
- Department of Epidemiology, Rollins School of Public Health, Emory University, USA
| | - Travis Sanchez
- Department of Epidemiology, Rollins School of Public Health, Emory University, USA
| | - Kayoko Shioda
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, USA
| | - Benjamin A Lopman
- Department of Epidemiology, Rollins School of Public Health, Emory University, USA; Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, USA
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13
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Clinical outcomes associated with SARS-CoV-2 Omicron (B.1.1.529) variant and BA.1/BA.1.1 or BA.2 subvariant infection in southern California. Nat Med 2022; 28:1933-1943. [PMID: 35675841 DOI: 10.1038/s41591-022-01887-z] [Citation(s) in RCA: 180] [Impact Index Per Article: 90.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Accepted: 06/06/2022] [Indexed: 02/06/2023]
Abstract
ABTRACT Epidemiologic surveillance has revealed decoupling of COVID-19 hospitalizations and deaths from case counts following emergence of the Omicron (B.1.1.529) SARS-CoV-2 variant globally. However, assessment of the relative severity of Omicron variant infections presents challenges because of differential acquired immune protection against Omicron and prior variants, and because longer-term changes have occurred in testing and healthcare practices. Here we show that Omicron variant infections were associated with substantially reduced risk of progression to severe clinical outcomes relative to time-matched Delta (B.1.617.2) variant infections within a large, integrated healthcare system in southern California. Adjusted hazard ratios (aHRs) for any hospital admission, symptomatic hospital admission, intensive care unit admission, mechanical ventilation, and death comparing cases with Omicron versus Delta variant infection were 0.59 (95% confidence interval: 0.51-0.69), 0.59 (0.51-0.68), 0.50 (0.29-0.87), 0.36 (0.18-0.72), and 0.21 (0.10-0.44) respectively. This reduced severity could not be explained by differential history of prior infection among cases with Omicron or Delta variant infection, and was starkest among cases not previously vaccinated against COVID-19 (aHR=0.40 [0.33-0.49] for any hospital admission and 0.14 [0.07-0.28] for death). Infections with the Omicron BA.2 subvariant were not associated with differential risk of severe outcomes in comparison to BA.1/BA.1.1 subvariant infections. Lower risk of severe clinical outcomes among cases with Omicron variant infection should inform public health response amid establishment of the Omicron variant as the dominant SARS-CoV-2 lineage globally.
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14
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Kanji JN, Nguyen LT, Plitt SS, Charlton CL, Fenton J, Braun S, Marohn C, Lau C, Svenson LW, Hinshaw D, Lutsiak C, Zelyas N, Mengel M, Tipples G. Seropositivity to SARS-CoV-2 in Alberta, Canada in a post-vaccination period (March 2021-July 2021). Infect Dis (Lond) 2022; 54:666-676. [PMID: 35642330 DOI: 10.1080/23744235.2022.2080250] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND The COVID-19 pandemic has necessitated the need to rapidly make public health decisions. We systematically evaluated SARS-CoV-2 seropositivity to understand local COVID-19 epidemiology and support evidence-based public health decision making. METHODS Residual blood samples were collected for SARS-CoV-2 receptor binding domain (RBD) IgG testing over a 1-5 day period monthly from 26 February 2021-9 July 2021 from six clinical laboratories across the province of Alberta, Canada. Monthly crude and adjusted (for age and gender) seropositivity were calculated. Results were linked to provincial administrative, laboratory, and vaccine databases. RESULTS 60,632 individual blood samples were tested. Vaccination data were available for 98.8% of samples. Adjusted RBD IgG positivity rose from 11.9% (95% confidence interval [CI] 11.9-12.0%) in March 2021 to 70.2% (95% CI 70.2-70.3%) in July 2021 (p < .0001). Seropositivity rose from 9.4% (95% CI 9.3-9.4%) in March 2021 to 20.2% (95% CI 20.1-20.2%) in July 2021 in unvaccinated Albertans. Unvaccinated seropositive individuals were from geographic areas with significantly (p < .001) lower median household income, lower proportion of married/common-law relationships, larger average household size and higher proportions of visible minorities compared to seronegative unvaccinated individuals. In July 2021, the age groups with the lowest and highest seropositivity in unvaccinated Albertans were those ≥80 years (12.0%, 95% CI 5.3-18.6%) and 20-29 years (24.2%, 95% CI 19.6-28.8%), respectively. Of seropositive unvaccinated individuals, 50.2% (95% CI 45.9-54.5%) had no record of prior SARS-CoV-2 molecular testing. CONCLUSIONS Longitudinal surveillance of SARS-CoV-2 seropositivity with data linkage is valuable for decision-making during the pandemic.
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Affiliation(s)
- Jamil N Kanji
- Public Health Laboratory, Alberta Precision Laboratories, Calgary, Canada.,Division of Infectious Diseases, Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Canada.,Department of Pathology and Laboratory Medicine, Cumming School of Medicine, University of Calgary, Calgary, Canada.,Department of Laboratory Medicine and Pathology, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Canada
| | | | - Sabrina S Plitt
- Centre for Communicable Diseases and Infection Control, Public Health Agency of Canada (PHAC), Ottawa, Canada.,Public Health Laboratory, Alberta Precision Laboratories, Edmonton, Canada
| | - Carmen L Charlton
- Department of Laboratory Medicine and Pathology, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Canada.,Public Health Laboratory, Alberta Precision Laboratories, Edmonton, Canada.,Li Ka Shing Institute of Virology, University of Alberta, Edmonton, Canada
| | - Jayne Fenton
- Public Health Laboratory, Alberta Precision Laboratories, Edmonton, Canada
| | - Sheila Braun
- Public Health Laboratory, Alberta Precision Laboratories, Calgary, Canada
| | - Carol Marohn
- Alberta Precision Laboratories, Edmonton, Canada
| | - Cheryl Lau
- Alberta Precision Laboratories, Edmonton, Canada
| | - Lawrence W Svenson
- School of Public Health, University of Alberta, Edmonton, Canada.,Alberta Health, Government of Alberta, Edmonton, Canada.,Department of Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Canada.,Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Canada
| | - Deena Hinshaw
- Alberta Health, Government of Alberta, Edmonton, Canada.,Department of Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Canada.,Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Canada
| | | | - Nathan Zelyas
- Department of Laboratory Medicine and Pathology, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Canada.,Public Health Laboratory, Alberta Precision Laboratories, Edmonton, Canada
| | - Michael Mengel
- Department of Laboratory Medicine and Pathology, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Canada.,Alberta Precision Laboratories, Edmonton, Canada
| | - Graham Tipples
- Public Health Laboratory, Alberta Precision Laboratories, Calgary, Canada.,Public Health Laboratory, Alberta Precision Laboratories, Edmonton, Canada.,Li Ka Shing Institute of Virology, University of Alberta, Edmonton, Canada.,Department of Medical Microbiology and Immunology, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Canada
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15
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Mehrotra ML, Lim E, Lamba K, Kamali A, Lai KW, Meza E, Szeto I, Robinson P, Tsai CT, Gebhart D, Fonseca N, Martin AB, Ley C, Scherf S, Watt J, Seftel D, Parsonnet J, Jain S. CalScope: Monitoring SARS-CoV-2 Seroprevalence from Vaccination and Prior Infection in Adults and Children in California May 2021– July 2021. Open Forum Infect Dis 2022; 9:ofac246. [PMID: 35855959 PMCID: PMC9129171 DOI: 10.1093/ofid/ofac246] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Accepted: 05/11/2022] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Understanding the distribution of SARS-CoV-2 antibodies from vaccination and/or prior infection is critical to the public health response to the pandemic. CalScope is a population-based serosurvey in 7 counties in California.
Methods
We invited 200,000 randomly sampled households to enroll up to 1 adult and 1 child between April 20, 2021 and June 16, 2021. We tested all specimen for antibodies against SARS-CoV-2 nucleocapsid and spike proteins, and each participant completed an online survey. We classified participants into categories: seronegative, antibodies from infection only, antibodies from infection and vaccination, and antibodies from vaccination only.
Results
11,161 households enrolled (5.6%), with 7,483 adults and 1,375 children completing antibody testing. As of June 2021, 33% (95%CI [28%, 37%]) of adults and 57% (95%CI[48%, 66%]) of children were seronegative; 18% (95%CI[14%, 22%]) of adults and 26% (95%CI[19%, 32%]) of children had antibodies from infection alone; 9% (95%CI[6%,11%]) of adults and 5% (95%CI[1%, 8%]) of children had antibodies from infection and vaccination; and 41% (95%CI[37%, 45%]) of adults and 13% (95%CI [7%, 18%]) of children had antibodies from vaccination alone.
Conclusions
As of June 2021, a third of adults and most children in California were seronegative. Serostatus varied regionally and by demographic group.
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Affiliation(s)
| | - Esther Lim
- California Department of Public Health, Richmond, CA, United States
| | - Katherine Lamba
- California Department of Public Health, Richmond, CA, United States
| | - Amanda Kamali
- California Department of Public Health, Richmond, CA, United States
| | - Kristina W. Lai
- California Department of Public Health, Richmond, CA, United States
| | - Erika Meza
- California Department of Public Health, Richmond, CA, United States
| | - Irvin Szeto
- Stanford University, School of Medicine, Palo Alto, CA, United States
| | - Peter Robinson
- Enable Biosciences, South San Francisco, CA, United States
| | | | - David Gebhart
- Enable Biosciences, South San Francisco, CA, United States
| | - Noemi Fonseca
- Enable Biosciences, South San Francisco, CA, United States
| | - Andrew B. Martin
- Stanford University, School of Medicine, Palo Alto, CA, United States
| | - Catherine Ley
- Stanford University, School of Medicine, Palo Alto, CA, United States
| | | | - James Watt
- California Department of Public Health, Richmond, CA, United States
| | - David Seftel
- Enable Biosciences, South San Francisco, CA, United States
| | - Julie Parsonnet
- Stanford University, School of Medicine, Palo Alto, CA, United States
| | - Seema Jain
- California Department of Public Health, Richmond, CA, United States
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16
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Klein C, Borsche M, Balck A, Föh B, Rahmöller J, Peters E, Knickmann J, Lane M, Vollstedt EJ, Elsner SA, Käding N, Hauswaldt S, Lange T, Hundt JE, Lehrian S, Giese J, Mischnik A, Niemann S, Maurer F, Homolka S, Paulowski L, Kramer J, Twesten C, Sina C, Gillessen-Kaesbach G, Busch H, Ehlers M, Taube S, Rupp J, Katalinic A. One-year surveillance of SARS-CoV-2 transmission of the ELISA cohort: A model for population-based monitoring of infection risk. SCIENCE ADVANCES 2022; 8:eabm5016. [PMID: 35427158 PMCID: PMC9012459 DOI: 10.1126/sciadv.abm5016] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/07/2023]
Abstract
With newly rising coronavirus disease 2019 (COVID-19) cases, important data gaps remain on (i) long-term dynamics of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection rates in fixed cohorts (ii) identification of risk factors, and (iii) establishment of effective surveillance strategies. By polymerase chain reaction and antibody testing of 1% of the local population and >90,000 app-based datasets, the present study surveilled a catchment area of 300,000 inhabitants from March 2020 to February 2021. Cohort (56% female; mean age, 45.6 years) retention was 75 to 98%. Increased risk for seropositivity was detected in several high-exposure groups, especially nurses. Unreported infections dropped from 92 to 29% during the study. "Contact to COVID-19-affected" was the strongest risk factor, whereas public transportation, having children in school, or tourism did not affect infection rates. With the first SARS-CoV-2 cohort study, we provide a transferable model for effective surveillance, enabling monitoring of reinfection rates and increased preparedness for future pandemics.
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Affiliation(s)
- Christine Klein
- Institute of Neurogenetics, University of Lübeck and University Hospital Schleswig-Holstein, Campus Lübeck, Lübeck, Germany
- Corresponding author.
| | - Max Borsche
- Institute of Neurogenetics, University of Lübeck and University Hospital Schleswig-Holstein, Campus Lübeck, Lübeck, Germany
| | - Alexander Balck
- Institute of Neurogenetics, University of Lübeck and University Hospital Schleswig-Holstein, Campus Lübeck, Lübeck, Germany
- Department of Neurology, University of Lübeckand and University Hospital Schleswig-Holstein, Campus Lübeck, Lübeck, Germany
| | - Bandik Föh
- Institute of Nutritional Medicine, University of Lübeck, Lübeck, Germany
- Department of Medicine I, University Hospital Schleswig-Holstein, Lübeck, Germany
| | - Johann Rahmöller
- Institute of Nutritional Medicine, University of Lübeck, Lübeck, Germany
- Department of Anesthesiology and Intensive Care, University Hospital Schleswig-Holstein, Lübeck, Germany
| | - Elke Peters
- Institute of Social Medicine and Epidemiology, University of Lübeck, Lübeck, Germany
| | - Jan Knickmann
- Institute of Virology and Cell Biology, University of Lübeck, Lübeck, Germany
| | - Miranda Lane
- Institute of Virology and Cell Biology, University of Lübeck, Lübeck, Germany
| | - Eva-Juliane Vollstedt
- Institute of Neurogenetics, University of Lübeck and University Hospital Schleswig-Holstein, Campus Lübeck, Lübeck, Germany
| | - Susanne A. Elsner
- Institute of Social Medicine and Epidemiology, University of Lübeck, Lübeck, Germany
| | - Nadja Käding
- Department of Infectious Diseases and Microbiology, University of Lübeck and University Hospital Schleswig-Holstein, Campus Lübeck, Lübeck, Germany
| | - Susanne Hauswaldt
- Department of Infectious Diseases and Microbiology, University of Lübeck and University Hospital Schleswig-Holstein, Campus Lübeck, Lübeck, Germany
| | - Tanja Lange
- Department of Rheumatology and Clinical Immunology, University of Lübeck and University Hospital Schleswig-Holstein, Campus Lübeck, Lübeck, Germany
| | - Jennifer E. Hundt
- Lübeck Institute of Experimental Dermatology (LIED), University of Lübeck, Lübeck, Germany
| | - Selina Lehrian
- Institute of Nutritional Medicine, University of Lübeck, Lübeck, Germany
| | - Julia Giese
- Institute of Nutritional Medicine, University of Lübeck, Lübeck, Germany
| | | | - Stefan Niemann
- Research Center Borstel, Leibniz Lung Center, Borstel, Germany
- German Center for Infection Research (DZIF), Partner site Hamburg-Lübeck-Borstel-Riems, Borstel, Germany
| | - Florian Maurer
- Research Center Borstel, Leibniz Lung Center, Borstel, Germany
| | - Susanne Homolka
- Research Center Borstel, Leibniz Lung Center, Borstel, Germany
| | - Laura Paulowski
- Research Center Borstel, Leibniz Lung Center, Borstel, Germany
| | - Jan Kramer
- Institute of Virology and Cell Biology, University of Lübeck, Lübeck, Germany
- LADR Laboratory Group Dr. Kramer & Colleagues, Geesthacht, Germany
| | | | - Christian Sina
- Institute of Nutritional Medicine, University of Lübeck, Lübeck, Germany
| | | | - Hauke Busch
- Lübeck Institute of Experimental Dermatology (LIED), University of Lübeck, Lübeck, Germany
| | - Marc Ehlers
- Institute of Nutritional Medicine, University of Lübeck, Lübeck, Germany
| | - Stefan Taube
- Institute of Virology and Cell Biology, University of Lübeck, Lübeck, Germany
| | - Jan Rupp
- Department of Infectious Diseases and Microbiology, University of Lübeck and University Hospital Schleswig-Holstein, Campus Lübeck, Lübeck, Germany
| | - Alexander Katalinic
- Institute of Social Medicine and Epidemiology, University of Lübeck, Lübeck, Germany
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Nelson KN, Siegler AJ, Sullivan PS, Bradley H, Hall E, Luisi N, Hipp-Ramsey P, Sanchez T, Shioda K, Lopman BA. Nationally Representative Social Contact Patterns among U.S. adults, August 2020-April 2021. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2022:2021.09.22.21263904. [PMID: 35378746 PMCID: PMC8978954 DOI: 10.1101/2021.09.22.21263904] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
The response to the COVID-19 pandemic in the U.S prompted abrupt and dramatic changes to social contact patterns. Monitoring changing social behavior is essential to provide reliable input data for mechanistic models of infectious disease, which have been increasingly used to support public health policy to mitigate the impacts of the pandemic. While some studies have reported on changing contact patterns throughout the pandemic., few have reported on differences in contact patterns among key demographic groups and none have reported nationally representative estimates. We conducted a national probability survey of US households and collected information on social contact patterns during two time periods: August-December 2020 (before widespread vaccine availability) and March-April 2021 (during national vaccine rollout). Overall, contact rates in Spring 2021 were similar to those in Fall 2020, with most contacts reported at work. Persons identifying as non-White, non-Black, non-Asian, and non-Hispanic reported high numbers of contacts relative to other racial and ethnic groups. Contact rates were highest in those reporting occupations in retail, hospitality and food service, and transportation. Those testing positive for SARS-CoV-2 antibodies reported a higher number of daily contacts than those who were seronegative. Our findings provide evidence for differences in social behavior among demographic groups, highlighting the profound disparities that have become the hallmark of the COVID-19 pandemic.
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Affiliation(s)
- Kristin N Nelson
- Department of Epidemiology, Rollins School of Public Health, Emory University
| | - Aaron J Siegler
- Department of Epidemiology, Rollins School of Public Health, Emory University
| | - Patrick S Sullivan
- Department of Epidemiology, Rollins School of Public Health, Emory University
| | - Heather Bradley
- Department of Population Health Sciences, Georgia State University School of Public Health
| | - Eric Hall
- School of Public Health, Oregon Health & Science University
| | - Nicole Luisi
- Department of Epidemiology, Rollins School of Public Health, Emory University
| | | | - Travis Sanchez
- Department of Epidemiology, Rollins School of Public Health, Emory University
| | - Kayoko Shioda
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University
| | - Benjamin A Lopman
- Department of Epidemiology, Rollins School of Public Health, Emory University
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Couture A, Lyons BC, Mehrotra ML, Sosa L, Ezike N, Ahmed FS, Brown CM, Yendell S, Azzam IA, Katić BJ, Cope A, Dickerson K, Stone J, Traxler LB, Dunn J, Davis LB, Reed C, Clarke KEN, Flannery B, Charles MD. SARS-CoV-2 Seroprevalence and Reported COVID-19 Cases in U.S. Children, August 2020—May 2021. Open Forum Infect Dis 2022; 9:ofac044. [PMID: 35198651 PMCID: PMC8860150 DOI: 10.1093/ofid/ofac044] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Accepted: 01/25/2022] [Indexed: 11/14/2022] Open
Abstract
Background Case-based surveillance of pediatric coronavirus disease 2019 (COVID-19) cases underestimates the prevalence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections among children and adolescents. Our objectives were to estimate monthly SARS-CoV-2 antibody seroprevalence and calculate ratios of SARS-CoV-2 infections to reported COVID-19 cases among children and adolescents in 8 US states. Methods Using data from the Nationwide Commercial Laboratory Seroprevalence Survey, we estimated monthly SARS-CoV-2 antibody seroprevalence among children aged 0–17 years from August 2020 through May 2021. We calculated and compared cumulative incidence of SARS-CoV-2 infection extrapolated from population-standardized seroprevalence of antibodies to SARS-CoV-2, cumulative COVID-19 case reports since March 2020, and infection-to-case ratios among persons of all ages and children aged 0–17 years for each state. Results Of 41 583 residual serum specimens tested, children aged 0–4, 5–11, and 12–17 years accounted for 1619 (3.9%), 10 507 (25.3%), and 29 457 (70.8%), respectively. Median SARS-CoV-2 antibody seroprevalence among children increased from 8% (range, 6%–20%) in August 2020 to 37% (range, 26%–44%) in May 2021. Estimated ratios of SARS-CoV-2 infections to reported COVID-19 cases in May 2021 ranged by state from 4.7–8.9 among children and adolescents to 2.2–3.9 for all ages combined. Conclusions Through May 2021 in selected states, the majority of children with serum specimens included in serosurveys did not have evidence of prior SARS-CoV-2 infection. Case-based surveillance underestimated the number of children infected with SARS-CoV-2 more than among all ages. Continued monitoring of pediatric SARS-CoV-2 antibody seroprevalence should inform prevention and vaccination strategies.
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Affiliation(s)
- Alexia Couture
- COVID-19 Emergency Response, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - B Casey Lyons
- COVID-19 Emergency Response, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | | | - Lynn Sosa
- Connecticut State Department of Public Health, Hartford, CT, USA
| | - Ngozi Ezike
- Illinois Department of Public Health, Springfield, IL, USA
| | - Farah S Ahmed
- Kansas Department of Health and Environment, Topeka, KS, USA
| | | | | | - Ihsan A Azzam
- Nevada Division of Public and Behavioral Health, Carson City, NV, USA
| | | | - Anna Cope
- COVID-19 Emergency Response, Centers for Disease Control and Prevention, Atlanta, GA, USA
- North Carolina Department of Health and Human Services, Raleigh, NC, USA
| | | | - Jolianne Stone
- Oklahoma State Department of Health, Oklahoma City, OK, USA
| | - L Brannon Traxler
- South Carolina Department of Health and Environmental Control, Columbia, SC, USA
| | - John Dunn
- Tennessee Department of Health, Nashville, TN, USA
| | - Lora B Davis
- Washington State Department of Health, Tumwater, WA, USA
| | - Carrie Reed
- COVID-19 Emergency Response, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Kristie E N Clarke
- COVID-19 Emergency Response, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Brendan Flannery
- COVID-19 Emergency Response, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Myrna D Charles
- COVID-19 Emergency Response, Centers for Disease Control and Prevention, Atlanta, GA, USA
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