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Emergence of SARS-CoV-2 variants of concern in the pediatric population of the United States

Dien Bard, J.; Bootwalla, M.; Leber, A.; Planet, P.; Moustafa, A.; Harris, R.; Chen, P. Y.; Shen, L.; Ostrow, D.; Maglinte, D.; Flores, J.; Somak, R.; Ranganathan, S.; Perlman, E.; Zheng, X.; Selvarangan, R.; Delaney, M.; Campos, J.; Drew, M.; LoTempio, J.; Dunn, J.; Jung, S.; Dominguez, S.; Judkins, A.; Gai, X.

2021-05-24 infectious diseases
10.1101/2021.05.22.21257660 medRxiv
Show abstract

The evolution of SARS-CoV2 virus has led to the emergence of variants of concern (VOC). Children, particularly <12 years old not yet eligible for vaccines, continue to be important reservoirs of SARS-CoV-2 yet VOC prevalence data in this population is lacking. We report data from a genomic surveillance program that includes 9 U.S. childrens hospitals. Analysis of SARS-CoV-2 genomes from 2119 patients <19 years old between 03/20 to 04/21 identified 252 VOCs and 560 VOC signature mutations, most from 10/20 onwards. From 02/21 to 04/21, B.1.1.7 prevalence increased from 3.85% to 72.22% corresponding with the decline of B.1.429/B.1.427 from 51.82% to 16.67% at one institution. 71.74% of the VOC signature mutations detected were in children <12 years old, including 33 cases of B.1.1.7 and 119 of B.1.429/B.1.427. There continues to be a need for ongoing genomic surveillance, particularly among young children who will be the last groups to be vaccinated.

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