Emergence of SARS-CoV-2 Alpha (B.1.1.7) variant, infection rates, antibody seroconversion and seroprevalence rates in secondary school students and staff: Active prospective surveillance, December 2020 to March 2021, England

Shamez N. Ladhani*, Georgina Ireland, Frances Baawuah, Joanne Beckmann, Ifeanyichukwu O. Okike, Shazaad Ahmad, Joanna Garstang, Andrew J. Brent, Bernadette Brent, Felicity Aiano, Zahin Amin-Chowdhury, Meaghan Kall, Ray Borrow, Ezra Linley, Maria Zambon, John Poh, Lenesha Warrener, Angie Lackenby, Joanna Ellis, Gayatri AmirthalingamKevin E. Brown, Mary E. Ramsay

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

Objectives: We assessed SARS-CoV-2 infection, seroprevalence and seroconversion in students and staff when secondary schools reopened in March 2021. Methods: We initiated SARS-CoV-2 surveillance in 18 secondary schools across six regions in September 2020. Participants provided nasal swabs for RT-PCR and blood samples for SARS-CoV-2 antibodies at the beginning (September 2020) and end (December 2020) of the autumn term and at the start of the spring term (March 2021). Findings: In March 2021, 1895 participants (1100 students:795 staff) were tested; 5.6% (61/1094) students and 4.4% (35/792) staff had laboratory-confirmed SARS-CoV-2 infection from December 2020-March 2021. Nucleoprotein-antibody seroprevalence was 36.3% (370/1018) in students and 31.9% (245/769) in staff, while spike-antibody prevalence was 39.5% (402/1018) and 59.8% (459/769), respectively, similar to regional community seroprevalence. Between December 2020 and March 2021, 14.8% (97/656; 95%CI: 12.2–17.7) students and 10.0% (59/590; 95%CI: 7.7–12.7) staff seroconverted. Weekly seroconversion rates were similar from September to December 2020 (8.0/1000) and from December 2020 to March 2021 (7.9/1000; students: 9.3/1,000; staff: 6.3/1,000). Interpretation: By March 2021, a third of secondary school students and staff had evidence of prior infection based on N-antibody seropositivity, and an additional third of staff had evidence of vaccine-induced immunity based on S-antibody seropositivity.

Original languageEnglish
JournalJournal of Infection
DOIs
Publication statusAccepted/In press - 2021

Bibliographical note

Funding Information:
This surveillance was funded by the Department of Health and Social Care (DHSC)

Funding Information:
The authors would like to thank the schools, headteachers, staff, families and their very brave children who took part in the sKIDsPLUS surveillance. The authors would also like to thank the staff in the Immunisation Department and in the Virus Reference Department (VRD) at PHE Colindale, as well as Sero-epidemiology Unit (SEU) at PHE Manchester for supporting the sKIDS surveillance.

Publisher Copyright:
© 2021

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