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Tang J, Wang Y, Lu W, Gao Z, Xu M, Wu L, Jin J. High SARS-CoV-2 infection rate in children unvaccinated with COVID-19 vaccine in Changzhou, China, shortly after lifting zero-COVID-19 policy in December 2022. BMC Infect Dis 2024; 24:560. [PMID: 38840046 PMCID: PMC11151613 DOI: 10.1186/s12879-024-09445-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2024] [Accepted: 05/29/2024] [Indexed: 06/07/2024] Open
Abstract
BACKGROUND China experienced an overwhelming COVID-19 pandemic from middle December 2022 to middle January 2023 after lifting the zero-COVID-19 policy on December 7, 2022. However, the infection rate was less studied. We aimed to investigate the SARS-CoV-2 infection rate in children shortly after discontinuation of the zero-COVID-19 policy. METHODS From February 20 to April 10, 2023, we included 393 children aged 8 months to less than 3 years who did not receive COVID-19 vaccination and 114 children aged 3 to 6 years who received inactivated COVID-19 vaccines based on the convenience sampling in this cross-sectional study. IgG and IgM antibodies against nucleocapsid (N) and subunit 1 of spike (S1) of SARS-CoV-2 (anti-N/S1) were measured with commercial kits (Shenzhen YHLO Biotech, China). RESULTS Of the 393 unvaccinated children (1.5 ± 0.6 years; 52.2% boys), 369 (93.9%) were anti-N/S1 IgG positive. Of the 114 vaccinated children (5.3 ± 0.9 years; 48.2% boys), 112 (98.2%) were anti-N/S1 IgG positive. None of the unvaccinated or vaccinated children was anti-N/S1 IgM positive. The median IgG antibody titers in vaccinated children (344.91 AU/mL) were significantly higher than that in unvaccinated children (42.80 AU/mL) (P < 0.0001). The positive rates and titers of anti-N/S1 IgG had no significant difference between boys and girls respectively. CONCLUSION Vast majority of children were infected with SARS-CoV-2 shortly after ending zero-COVID-19 policy in China. Whether these unvaccinated infected children should receive COVID-19 vaccine merits further investigation.
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Affiliation(s)
- Jie Tang
- Department of Obstetrics and Gynecology, Wujin Hospital Affiliated with Jiangsu University, Changzhou, Jiangsu, 213017, China.
- Department of Obstetrics and Gynecology, The Wujin Clinical College of Xuzhou Medical University, Changzhou, Jiangsu, 213017, China.
| | - Yong Wang
- Department of Clinical Laboratory, Wujin People's hospital, Changzhou, Jiangsu, 213017, China
| | - Weiqin Lu
- Department of Respiratory Diseases, Changzhou Hospital of Traditional Chinese Medicine, Changzhou, Jiangsu, 213003, China
| | - Zhihong Gao
- Department of Clinical Laboratory, Wujin People's hospital, Changzhou, Jiangsu, 213017, China
| | - Mingfeng Xu
- Department of Pediatrics, Wujin People's hospital, Changzhou, Jiangsu, 213017, China
| | - Lin Wu
- Department of Infection Management, Changzhou Hospital of Traditional Chinese Medicine, Changzhou, Jiangsu, 213003, China
| | - Jianhua Jin
- Department of Oncology, Wujin Hospital Affiliated with Jiangsu University, Changzhou, Jiangsu, 213017, China.
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Sobczak M, Pawliczak R. Was China's zero-COVID policy the right choice? The multiple factor analysis of variables that affected the course of COVID-19 pandemic in China. Front Public Health 2023; 11:1252370. [PMID: 38125847 PMCID: PMC10731256 DOI: 10.3389/fpubh.2023.1252370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Accepted: 11/10/2023] [Indexed: 12/23/2023] Open
Abstract
Background After 3 years of the COVID-19 pandemic and zero-COVID policy, a rapid increase in the number of daily COVID-19 infections was observed in China from November to December 2022. Therefore, we decided to analyze the factors that have been related to the COVID-19 pandemic in China. Methods The multiple factor analysis was conducted, using the data from publicly available databases from the beginning of the COVID-19 pandemic to 30 January 2023. Results Our study showed that each year of the pandemic in China had different profiles and can be described by different variables: year 2020 was characterized by restrictions, such as international travel controls, stay at home requirements, and health system policies including contact tracing and protection of older adults; year 2021 was characterized by Alpha, Beta, Gamma, and Delta variants; 2022 was characterized by new cases per million, Omicron lineages, and a few restrictions-related variables; and year 2023 was mainly described by the number of new deaths per million and Omicron variant 22B (BA.5) but also by testing and vaccination policies, as well as the number of people fully vaccinated per 100 and total boosters per 100. Conclusion The COVID-19 pandemic has changed over time. Therefore, the anti-pandemic policies implemented must be dynamic and adapted to the current situation.
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Affiliation(s)
| | - Rafał Pawliczak
- Department of Immunopathology, Division of Biomedical Science, Faculty of Medicine, Medical University of Lodz, Łódź, Poland
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Zhou YH, Xu C, Tao Y, Gu M, Zhou G, Zhou W, Jin Y, Xie J, Xu B, Zhou W, Chen J, Shi W. Incidence of SARS-CoV-2 infection in children shortly after ending zero-COVID-19 policy in China on December 7, 2022: a cross-sectional, multicenter, seroepidemiological study. Front Public Health 2023; 11:1283158. [PMID: 38026391 PMCID: PMC10666904 DOI: 10.3389/fpubh.2023.1283158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Accepted: 10/19/2023] [Indexed: 12/01/2023] Open
Abstract
Background China discontinued the zero-COVID-19 policy on December 7, 2022, and then COVID-19 surged mid-December 2022 through mid-January 2023. However, the actual incidence was unknown. This study aimed to estimate the incidence of SARS-CoV-2 infection in children shortly after ending the zero-COVID-19 policy. Methods This multicenter cross-sectional study included 1,065 children aged 8 months to 12 years from seven hospitals at six regions across Jiangsu province, based on the convenience sampling, from February 10 to March 10, 2023. Group I comprised 324 children aged 8 months-2 years without COVID-19 vaccination, group II consisted of 338 preschool children aged 3-5 years with varied vaccination history, and group III contained 403 primary school children aged 6-12 years with mostly vaccinated. The COVID-19 vaccines were composed of inactivated SARS-CoV-2. In addition, 96 children's sera collected in 2014 were included as negative controls. IgG and IgM antibodies against nucleocapsid (N) and subunit 1 of spike (S1) of SARS-CoV-2 (anti-N/S1) were measured with commercial kits (YHLO Biotech, Shenzhen, China). Results None of the 96 children (5.1 ± 3.5 years; 58.3% boys) in 2014 was positive for anti-N/S1 IgG or IgM. Of the 1,065 children (5.0 ± 3.5 years; 56.0% boys), 988 (92.8%) were anti-N/S1 IgG positive but none was anti-N/S1 IgM positive. The positive rate of anti-N/S1 IgG in Group I, II, and III was 90.4, 88.5, and 98.3%, respectively, with significantly higher in group III than in groups I and II (p < 0.0001). The median antibody titers in group III (381.61 AU/ml) were much higher than that in group I (38.34 AU/ml) and II (51.88 AU/ml; p < 0.0001). Conclusion More than 90% children experienced SARS-CoV-2 infection shortly after ending zero-COVID-19 policy in China, much higher than estimated infections by other studies. The widespread SARS-CoV-2 infection in unvaccinated children should be influential on the policy of COVID-19 vaccination in children in the future.
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Affiliation(s)
- Yi-Hua Zhou
- Departments of Laboratory Medicine and Infectious Diseases, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, and Jiangsu Key Laboratory for Molecular Medicine, Nanjing University, Nanjing, Jiangsu, China
| | - Chenyu Xu
- Department of Obstetrics and Gynecology, Zhenjiang Fourth People’s Hospital, Zhenjiang, Jiangsu, China
| | - Yue Tao
- Departments of Laboratory Medicine and Infectious Diseases, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, and Jiangsu Key Laboratory for Molecular Medicine, Nanjing University, Nanjing, Jiangsu, China
| | - Meng Gu
- Department of Clinical Laboratory, Affiliated Changzhou Children's Hospital of Nantong University, Changzhou Children's Hospital, Changzhou, Jiangsu, China
| | - Guiping Zhou
- Department of Clinical Laboratory, Yixing Second People’s Hospital, Yixing, Jiangsu, China
| | - Wei Zhou
- Department of Clinical Laboratory, The First People’s Hospital of Changzhou, Changzhou, Jiangsu, China
| | - Yue Jin
- Department of Clinical Laboratory, Huai'an Second People's Hospital and the Affiliated Huai'an Hospital of Xuzhou Medical University, Huai’an, Jiangsu, China
| | - Jun Xie
- Department of Clinical Laboratory, People's Hospital of Xuyi County, Xuyi, Jiangsu, China
| | - Biyun Xu
- Medical Statistics and Analysis Center, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, Jiangsu, China
| | - Wensan Zhou
- Departments of Laboratory Medicine and Infectious Diseases, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, and Jiangsu Key Laboratory for Molecular Medicine, Nanjing University, Nanjing, Jiangsu, China
| | - Junhao Chen
- Departments of Laboratory Medicine and Infectious Diseases, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, and Jiangsu Key Laboratory for Molecular Medicine, Nanjing University, Nanjing, Jiangsu, China
| | - Weifeng Shi
- Department of Clinical Laboratory, The First People’s Hospital of Changzhou, Changzhou, Jiangsu, China
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Zhang W, Li L, Zhou Z, Liu Q, Wang G, Liu D. Cost-effectiveness of Paxlovid in reducing severe COVID-19 and mortality in China. Front Public Health 2023; 11:1174879. [PMID: 37404282 PMCID: PMC10315619 DOI: 10.3389/fpubh.2023.1174879] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Accepted: 05/31/2023] [Indexed: 07/06/2023] Open
Abstract
Objectives To assess the cost-effectiveness of Paxlovid in reducing severe COVID-19 and its associated morality, and to investigate the affordable price of Paxlovid in China. Materials and methods Using a Markov model, two interventions by Paxlovid prescription (with and without prescription) were compared in terms of COVID-19-related clinical outcomes and economic loss. COVID-related costs were collected from the societal perspective. Effectiveness data were obtained from literature. The primary outcomes were total social cost, disability adjusted life-years (DALYs) and net monetary benefit (NMB). Scenario analyses were performed to investigate the affordable price of Paxlovid in China. Deterministic sensitivity analyses (DSA) and probabilistic sensitivity analysis (PSA) were performed to verify the model robustness. Results Compared with the non-Paxlovid cohort, the NMBs of the Paxlovid cohort were only higher in the subgroup of patients aged over 80 years old, regardless of their vaccination status. Our scenario analysis found that, the price ceiling of Paxlovid/box for it to be cost-effective was RMB 8,993 (8,970-9,009) in those aged over 80 years old who were not vaccinated, which is the highest; and was RMB 35 (27-45) in those aged 40-59 years old who were vaccinated, which is the lowest. Sensitivity analyses found that the incremental NMB for the vaccinated people aged over 80 years was most sensitive to the efficacy of Paxlovid and the cost-effectiveness probability of Paxlovid increased with its decreasing price. Conclusion Under the current marketing price of Paxlovid/box (RMB 1,890), using Paxlovid was only cost-effective in people aged over 80 years old regardless of their vaccination status.
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Affiliation(s)
- Weina Zhang
- Department of Pharmacy, Northwest Women’s and Children’s Hospital, Xi’an, Shaanxi, China
| | - Lanfang Li
- Department of Pharmacy, Affiliated Hospital of Jining Medical University, Jining, China
| | - Zhen Zhou
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Qiao Liu
- Department of Pharmacy, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Guan Wang
- State-Owned Assets Management Department, Northwest University of Political Science and Law, Xi’an, Shaanxi, China
| | - Dan Liu
- Reproductive Medicine Center, Department of Obstetrics and Gynecology, The Second Xiangya Hospital of Central South University, Changsha, China
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