Trends in SARS-CoV-2 infection and vaccination in school staff, students and their household members from 2020 to 2022 in Wales, UK: an electronic cohort study

Author:

Lowthian Emily12ORCID,Abbasizanjani Hoda1ORCID,Bedston Stuart1ORCID,Akbari Ashley1ORCID,Cowley Laura1ORCID,Fry Richard1,Owen Rhiannon K1,Hollinghurst Joe1ORCID,Rudan Igor3,Beggs Jillian4,Marchant Emily12,Torabi Fatemeh1,Lusignan Simon de5,Crick Tom2ORCID,Moore Graham6,Sheikh Aziz4,Lyons Ronan A1

Affiliation:

1. Population Data Science, Swansea University Medical School, Faculty of Medicine, Health and Life Science, Swansea University, SA2 8PP, UK

2. Department of Education & Childhood Studies, School of Social Sciences, Faculty of Humanities and Social Sciences, Swansea University, SA2 8PP, UK

3. Centre for Global Health, Usher Institute, The University of Edinburgh, Edinburgh, EH8 9AG, UK

4. Usher Institute, The University of Edinburgh, Edinburgh, EH8 9AG, UK

5. Nuffield Department of Primary Care Health Sciences, University of Oxford, OX2 6GG, UK

6. DECIPHer, SPARK, Cardiff University, Cardiff, CF24 4HQ, UK

Abstract

Objectives We investigated SARS-CoV-2 infection trends, risk of SARS-CoV-2 infection and COVID-19 vaccination uptake among school staff, students and their household members in Wales, UK. Design Seven-day average of SARS-CoV-2 infections and polymerase chain reaction tests per 1000 people daily, cumulative incidence of COVID-19 vaccination uptake and multi-level Poisson models with time-varying covariates. Setting National electronic cohort between September 2020 and May 2022 when several variants were predominant in the UK (Alpha, Delta and Omicron). Participants School students aged 4 to 10/11 years (primary school and younger middle school, n = 238,163), and 11 to 15/16 years (secondary school and older middle school, n = 182,775), school staff in Wales ( n = 47,963) and the household members of students and staff ( n = 697,659). Main outcome measures SARS-CoV-2 infection and COVID-19 vaccination uptake. Results School students had a sustained period of high infection rates compared with household members after August 2021. Primary schedule vaccination uptake was highest among staff (96.3%) but lower for household members (72.2%), secondary and older middle school students (59.8%), and primary and younger middle school students (3.3%). Multi-level Poisson models showed that vaccination was associated with a lower risk of SARS-CoV-2 infection. The Delta variant posed a greater infection risk for students than the Alpha variant. However, Omicron was a larger risk for staff and household members. Conclusions Public health bodies should be informed of the protection COVID-19 vaccines afford, with more research being required for younger populations. Furthermore, schools require additional support in managing new, highly transmissible variants. Further research should examine the mechanisms between child deprivation and SARS-CoV-2 infection.

Funder

Academy of Medical Sciences

ADR Wales

Wellcome Trust

Health Data Research UK

Medical Research Council

Diabetes UK Springboard Award

British Heart Foundation

Health and Care Research Wales

The Government Department of Business, Energy, Industrial Strategy

Publisher

SAGE Publications

Subject

General Medicine

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