The Role of Children in SARS-CoV-2 Variant of Concerns Transmission within Households: A Meta-analysis

BackgroundMeta-analysis and single site studies have established that children are less infectious within a household when positive for ancestral SARS-CoV-2. In addition, children appear less susceptible to infection when exposed to ancestral SARS-CoV-2 within a household. The emergence of SARS-CoV-2 variants of concern (VOC) has been associated with an increased number of pediatric infections worldwide. However, the role of children in the household transmission of VOCs, relative to the ancestral virus, remains unclear. MethodsHere, we perform a meta-analysis of the role of children in the household transmission of both ancestral SARS-CoV-2 and SARS-CoV-2 VOCs. Results: Unlike the ancestral virus, children infected with VOCs spread SARS-CoV-2 to an equivalent number of household contacts as infected adults. Similarly, unlike the ancestral virus, children within a household were equally as likely as adults to acquire SARS-CoV-2 from an infected family member. Interestingly, this same observation was noted when unvaccinated children exposed to VOCs were compared to unvaccinated adults exposed to VOCs. ConclusionsTogether, these data suggest that the emergence of VOCs were associated with a fundamental shift in the epidemiology of SARS-CoV-2. This is unlikely to solely be the result of age-dependent differences in vaccination during the VOCs period and instead may reflect virus evolution over the course of the pandemic. summaryThe role of children in the household transmission of VOCs, relative to the ancestral virus, remains unclear. Using a meta-analysis we show that the emergence of VOCs were associated with a fundamental shift in the epidemiology of SARS-CoV-2