The seroprevalence of SARS-CoV-2-specific antibodies in Australian children: A crosssectional study

Archana Koirala; Jocelynne McRae; Philip N. Britton; Marnie Downes; Shayal A. Prasad; Suellen Nicholson; Noni E. Winkler; Matthew V.N. O'Sullivan; Fatima Gondalwala; Cecile Castellano; Emma Carey; Alexandra Hendry; Nigel Crawford; Ushma Wadia; Peter Richmond; Helen S. Marshall; Julia E. Clark; Joshua R. Francis; Jeremy Carr; Adam Bartlett; Brendan McMullan; Justin Skowno; Donald Hannah; Andrew Davidson; Britta S. von Ungern-Sternberg; Paul Lee-Archer; Laura L. Burgoyne; Edith B. Waugh; John B. Carlin; Zin Naing; Nicole Kerly; Alissa McMinn; Guillian Hunter; Christine Heath; Natascha D'Angelo; Carolyn Finucane; Laura A. Francis; Sonia Dougherty; William Rawlinson; Theo Karapanagiotidis; Natalie Cain; Rianne Brizuela; Christopher C. Blyth; Nicholas Wood; Kristine Macartney

doi:10.1371/journal.pone.0300555

The seroprevalence of SARS-CoV-2-specific antibodies in Australian children: A crosssectional study

Archana Koirala, Jocelynne McRae, Philip N. Britton, Marnie Downes, Shayal A. Prasad, Suellen Nicholson, Noni E. Winkler, Matthew V.N. O'Sullivan, Fatima Gondalwala, Cecile Castellano, Emma Carey, Alexandra Hendry, Nigel Crawford, Ushma Wadia, Peter Richmond, Helen S. Marshall, Julia E. Clark, Joshua R. Francis, Jeremy Carr, Adam BartlettBrendan McMullan, Justin Skowno, Donald Hannah, Andrew Davidson, Britta S. von Ungern-Sternberg, Paul Lee-Archer, Laura L. Burgoyne, Edith B. Waugh, John B. Carlin, Zin Naing, Nicole Kerly, Alissa McMinn, Guillian Hunter, Christine Heath, Natascha D'Angelo, Carolyn Finucane, Laura A. Francis, Sonia Dougherty, William Rawlinson, Theo Karapanagiotidis, Natalie Cain, Rianne Brizuela, Christopher C. Blyth, Nicholas Wood, Kristine Macartney

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Abstract

Background

Following reduction of public health and social measures concurrent with SARS-CoV-2 Omicron emergence in late 2021 in Australia, COVID-19 case notification rates rose rapidly. As rates of direct viral testing and reporting dropped, true infection rates were most likely to be underestimated.

Objective

To better understand infection rates and immunity in this population, we aimed to estimate SARS-CoV-2 seroprevalence in Australians aged 0-19 years.

Methods

We conducted a national cross sectional serosurvey from June 1, 2022, to August 31, 2022, in children aged 0-19 years undergoing an anesthetic procedure at eight tertiary pediatric hospitals. Participant questionnaires were administered, and blood samples tested using the Roche Elecsys Anti-SARS-CoV-2 total spike and nucleocapsid antibody assays. Spike and nucleocapsid seroprevalence adjusted for geographic and socioeconomic imbalances in the participant sample compared to the Australian population was estimated using multilevel regression and poststratification within a Bayesian framework.

Results

Blood was collected from 2,046 participants (median age: 6.6 years). The overall adjusted seroprevalence of spike-antibody was 92.1% (95% credible interval (CrI) 91.0-93.3%) and nucleocapsid-antibody was 67.0% (95% CrI 64.6-69.3). In unvaccinated children spike and nucleocapsid antibody seroprevalences were 84.2% (95% CrI 81.9-86.5) and 67.1% (95% CrI 64.0-69.8), respectively. Seroprevalence was similar across geographic remoteness index and socioeconomic quintiles. Nucleocapsid antibody seroprevalence increased with age while the point seroprevalence of the spike antibody seroprevalence decreased in the first year of life and then increased to 97.8 (95% Crl 96.1-99.2) by 12-15 years of age.

Conclusion

Most Australian children and adolescents aged 0-19 years, across all jurisdictions were infected with SARS-CoV-2 by August 2022, suggesting rapid and uniform spread across the population in a very short time period. High seropositivity in unvaccinated children informed COVID-19 vaccine recommendations in Australia.

Original language	English
Article number	e0300555
Number of pages	21
Journal	PLoS One
Volume	19
Issue number	9
DOIs	https://doi.org/10.1371/journal.pone.0300555
Publication status	Published - Sept 2024
Externally published	Yes

Keywords

SARS-CoV-2
antibodies
Australian children

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1371/journal.pone.0300555Licence: CC BY

Final published versionFinal published version, 1.86 MBLicence: CC BY

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Koirala, A., McRae, J., Britton, P. N., Downes, M., Prasad, S. A., Nicholson, S., Winkler, N. E., O'Sullivan, M. V. N., Gondalwala, F., Castellano, C., Carey, E., Hendry, A., Crawford, N., Wadia, U., Richmond, P., Marshall, H. S., Clark, J. E., Francis, J. R., Carr, J., ... Macartney, K. (2024). The seroprevalence of SARS-CoV-2-specific antibodies in Australian children: A crosssectional study. PLoS One, 19(9), Article e0300555. https://doi.org/10.1371/journal.pone.0300555

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title = "The seroprevalence of SARS-CoV-2-specific antibodies in Australian children: A crosssectional study",

abstract = "Background Following reduction of public health and social measures concurrent with SARS-CoV-2 Omicron emergence in late 2021 in Australia, COVID-19 case notification rates rose rapidly. As rates of direct viral testing and reporting dropped, true infection rates were most likely to be underestimated. Objective To better understand infection rates and immunity in this population, we aimed to estimate SARS-CoV-2 seroprevalence in Australians aged 0-19 years. Methods We conducted a national cross sectional serosurvey from June 1, 2022, to August 31, 2022, in children aged 0-19 years undergoing an anesthetic procedure at eight tertiary pediatric hospitals. Participant questionnaires were administered, and blood samples tested using the Roche Elecsys Anti-SARS-CoV-2 total spike and nucleocapsid antibody assays. Spike and nucleocapsid seroprevalence adjusted for geographic and socioeconomic imbalances in the participant sample compared to the Australian population was estimated using multilevel regression and poststratification within a Bayesian framework. Results Blood was collected from 2,046 participants (median age: 6.6 years). The overall adjusted seroprevalence of spike-antibody was 92.1% (95% credible interval (CrI) 91.0-93.3%) and nucleocapsid-antibody was 67.0% (95% CrI 64.6-69.3). In unvaccinated children spike and nucleocapsid antibody seroprevalences were 84.2% (95% CrI 81.9-86.5) and 67.1% (95% CrI 64.0-69.8), respectively. Seroprevalence was similar across geographic remoteness index and socioeconomic quintiles. Nucleocapsid antibody seroprevalence increased with age while the point seroprevalence of the spike antibody seroprevalence decreased in the first year of life and then increased to 97.8 (95% Crl 96.1-99.2) by 12-15 years of age. Conclusion Most Australian children and adolescents aged 0-19 years, across all jurisdictions were infected with SARS-CoV-2 by August 2022, suggesting rapid and uniform spread across the population in a very short time period. High seropositivity in unvaccinated children informed COVID-19 vaccine recommendations in Australia.",

keywords = "SARS-CoV-2, antibodies, Australian children",

author = "Archana Koirala and Jocelynne McRae and Britton, {Philip N.} and Marnie Downes and Prasad, {Shayal A.} and Suellen Nicholson and Winkler, {Noni E.} and O'Sullivan, {Matthew V.N.} and Fatima Gondalwala and Cecile Castellano and Emma Carey and Alexandra Hendry and Nigel Crawford and Ushma Wadia and Peter Richmond and Marshall, {Helen S.} and Clark, {Julia E.} and Francis, {Joshua R.} and Jeremy Carr and Adam Bartlett and Brendan McMullan and Justin Skowno and Donald Hannah and Andrew Davidson and {von Ungern-Sternberg}, {Britta S.} and Paul Lee-Archer and Burgoyne, {Laura L.} and Waugh, {Edith B.} and Carlin, {John B.} and Zin Naing and Nicole Kerly and Alissa McMinn and Guillian Hunter and Christine Heath and Natascha D'Angelo and Carolyn Finucane and Francis, {Laura A.} and Sonia Dougherty and William Rawlinson and Theo Karapanagiotidis and Natalie Cain and Rianne Brizuela and Blyth, {Christopher C.} and Nicholas Wood and Kristine Macartney",

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doi = "10.1371/journal.pone.0300555",

language = "English",

volume = "19",

journal = "PLoS One",

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Koirala, A, McRae, J, Britton, PN, Downes, M, Prasad, SA, Nicholson, S, Winkler, NE, O'Sullivan, MVN, Gondalwala, F, Castellano, C, Carey, E, Hendry, A, Crawford, N, Wadia, U, Richmond, P, Marshall, HS, Clark, JE, Francis, JR, Carr, J, Bartlett, A, McMullan, B, Skowno, J, Hannah, D, Davidson, A, von Ungern-Sternberg, BS, Lee-Archer, P, Burgoyne, LL, Waugh, EB, Carlin, JB, Naing, Z, Kerly, N, McMinn, A, Hunter, G, Heath, C, D'Angelo, N, Finucane, C, Francis, LA, Dougherty, S, Rawlinson, W, Karapanagiotidis, T, Cain, N, Brizuela, R, Blyth, CC, Wood, N & Macartney, K 2024, 'The seroprevalence of SARS-CoV-2-specific antibodies in Australian children: A crosssectional study', PLoS One, vol. 19, no. 9, e0300555. https://doi.org/10.1371/journal.pone.0300555

TY - JOUR

T1 - The seroprevalence of SARS-CoV-2-specific antibodies in Australian children

T2 - A crosssectional study

AU - Koirala, Archana

AU - McRae, Jocelynne

AU - Britton, Philip N.

AU - Downes, Marnie

AU - Prasad, Shayal A.

AU - Nicholson, Suellen

AU - Winkler, Noni E.

AU - O'Sullivan, Matthew V.N.

AU - Gondalwala, Fatima

AU - Castellano, Cecile

AU - Carey, Emma

AU - Hendry, Alexandra

AU - Crawford, Nigel

AU - Wadia, Ushma

AU - Richmond, Peter

AU - Marshall, Helen S.

AU - Clark, Julia E.

AU - Francis, Joshua R.

AU - Carr, Jeremy

AU - Bartlett, Adam

AU - McMullan, Brendan

AU - Skowno, Justin

AU - Hannah, Donald

AU - Davidson, Andrew

AU - von Ungern-Sternberg, Britta S.

AU - Lee-Archer, Paul

AU - Burgoyne, Laura L.

AU - Waugh, Edith B.

AU - Carlin, John B.

AU - Naing, Zin

AU - Kerly, Nicole

AU - McMinn, Alissa

AU - Hunter, Guillian

AU - Heath, Christine

AU - D'Angelo, Natascha

AU - Finucane, Carolyn

AU - Francis, Laura A.

AU - Dougherty, Sonia

AU - Rawlinson, William

AU - Karapanagiotidis, Theo

AU - Cain, Natalie

AU - Brizuela, Rianne

AU - Blyth, Christopher C.

AU - Wood, Nicholas

AU - Macartney, Kristine

PY - 2024/9

Y1 - 2024/9

N2 - Background Following reduction of public health and social measures concurrent with SARS-CoV-2 Omicron emergence in late 2021 in Australia, COVID-19 case notification rates rose rapidly. As rates of direct viral testing and reporting dropped, true infection rates were most likely to be underestimated. Objective To better understand infection rates and immunity in this population, we aimed to estimate SARS-CoV-2 seroprevalence in Australians aged 0-19 years. Methods We conducted a national cross sectional serosurvey from June 1, 2022, to August 31, 2022, in children aged 0-19 years undergoing an anesthetic procedure at eight tertiary pediatric hospitals. Participant questionnaires were administered, and blood samples tested using the Roche Elecsys Anti-SARS-CoV-2 total spike and nucleocapsid antibody assays. Spike and nucleocapsid seroprevalence adjusted for geographic and socioeconomic imbalances in the participant sample compared to the Australian population was estimated using multilevel regression and poststratification within a Bayesian framework. Results Blood was collected from 2,046 participants (median age: 6.6 years). The overall adjusted seroprevalence of spike-antibody was 92.1% (95% credible interval (CrI) 91.0-93.3%) and nucleocapsid-antibody was 67.0% (95% CrI 64.6-69.3). In unvaccinated children spike and nucleocapsid antibody seroprevalences were 84.2% (95% CrI 81.9-86.5) and 67.1% (95% CrI 64.0-69.8), respectively. Seroprevalence was similar across geographic remoteness index and socioeconomic quintiles. Nucleocapsid antibody seroprevalence increased with age while the point seroprevalence of the spike antibody seroprevalence decreased in the first year of life and then increased to 97.8 (95% Crl 96.1-99.2) by 12-15 years of age. Conclusion Most Australian children and adolescents aged 0-19 years, across all jurisdictions were infected with SARS-CoV-2 by August 2022, suggesting rapid and uniform spread across the population in a very short time period. High seropositivity in unvaccinated children informed COVID-19 vaccine recommendations in Australia.

AB - Background Following reduction of public health and social measures concurrent with SARS-CoV-2 Omicron emergence in late 2021 in Australia, COVID-19 case notification rates rose rapidly. As rates of direct viral testing and reporting dropped, true infection rates were most likely to be underestimated. Objective To better understand infection rates and immunity in this population, we aimed to estimate SARS-CoV-2 seroprevalence in Australians aged 0-19 years. Methods We conducted a national cross sectional serosurvey from June 1, 2022, to August 31, 2022, in children aged 0-19 years undergoing an anesthetic procedure at eight tertiary pediatric hospitals. Participant questionnaires were administered, and blood samples tested using the Roche Elecsys Anti-SARS-CoV-2 total spike and nucleocapsid antibody assays. Spike and nucleocapsid seroprevalence adjusted for geographic and socioeconomic imbalances in the participant sample compared to the Australian population was estimated using multilevel regression and poststratification within a Bayesian framework. Results Blood was collected from 2,046 participants (median age: 6.6 years). The overall adjusted seroprevalence of spike-antibody was 92.1% (95% credible interval (CrI) 91.0-93.3%) and nucleocapsid-antibody was 67.0% (95% CrI 64.6-69.3). In unvaccinated children spike and nucleocapsid antibody seroprevalences were 84.2% (95% CrI 81.9-86.5) and 67.1% (95% CrI 64.0-69.8), respectively. Seroprevalence was similar across geographic remoteness index and socioeconomic quintiles. Nucleocapsid antibody seroprevalence increased with age while the point seroprevalence of the spike antibody seroprevalence decreased in the first year of life and then increased to 97.8 (95% Crl 96.1-99.2) by 12-15 years of age. Conclusion Most Australian children and adolescents aged 0-19 years, across all jurisdictions were infected with SARS-CoV-2 by August 2022, suggesting rapid and uniform spread across the population in a very short time period. High seropositivity in unvaccinated children informed COVID-19 vaccine recommendations in Australia.

KW - SARS-CoV-2

KW - antibodies

KW - Australian children

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U2 - 10.1371/journal.pone.0300555

DO - 10.1371/journal.pone.0300555

M3 - Article

C2 - 39292730

AN - SCOPUS:85204388521

SN - 1932-6203

VL - 19

JO - PLoS One

JF - PLoS One

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M1 - e0300555

ER -

The seroprevalence of SARS-CoV-2-specific antibodies in Australian children: A crosssectional study

Abstract

Keywords

UN SDGs

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