Antibody persistence and neutralising activity in primary school students and staff: Prospective active surveillance, June to December 2020, England

Georgina Ireland; Anna Jeffery-Smith; Maria Zambon; Katja Hoschler; Ross Harris; John Poh; Frances Baawuah; Joanne Beckmann; Ifeanyichukwu O. Okike; Shazaad Ahmad; Joanna Garstang; Andrew J. Brent; Bernadette Brent; Felicity Aiano; Zahin Amin-Chowdhury; Louise Letley; Samuel E.I. Jones; Meaghan Kall; Monika Patel; Robin Gopal; Ray Borrow; Ezra Linley; Gayatri Amirthalingam; Kevin E. Brown; Mary E. Ramsay; Shamez N. Ladhani

doi:10.1016/j.eclinm.2021.101150

Antibody persistence and neutralising activity in primary school students and staff: Prospective active surveillance, June to December 2020, England

Georgina Ireland^*, Anna Jeffery-Smith, Maria Zambon, Katja Hoschler, Ross Harris, John Poh, Frances Baawuah, Joanne Beckmann, Ifeanyichukwu O. Okike, Shazaad Ahmad, Joanna Garstang, Andrew J. Brent, Bernadette Brent, Felicity Aiano, Zahin Amin-Chowdhury, Louise Letley, Samuel E.I. Jones, Meaghan Kall, Monika Patel, Robin GopalRay Borrow, Ezra Linley, Gayatri Amirthalingam, Kevin E. Brown, Mary E. Ramsay, Shamez N. Ladhani

^*Corresponding author for this work

Research output: Contribution to journal › Article › peer-review

5 Citations (Scopus)

Abstract

Background: Prospective, longitudinal SARS-CoV-2 sero-surveillance in schools across England was initiated after the first national lockdown, allowing comparison of child and adult antibody responses over time. Methods: Prospective active serological surveillance in 46 primary schools in England tested for SARS-CoV-2 antibodies during June, July and December 2020. Samples were tested for nucleocapsid (N) and receptor binding domain (RBD) antibodies, to estimate antibody persistence at least 6 months after infection, and for the correlation of N, RBD and live virus neutralising activity. Findings: In June 2020, 1,344 staff and 835 students were tested. Overall, 11.5% (95%CI: 9.4–13.9) and 11.3% (95%CI: 9.2–13.6; p = 0.88) of students had nucleoprotein and RBD antibodies, compared to 15.6% (95%CI: 13.7–17.6) and 15.3% (95%CI: 13.4–17.3; p = 0.83) of staff. Live virus neutralising activity was detected in 79.8% (n = 71/89) of nucleocapsid and 85.5% (71/83) of RBD antibody positive children. RBD antibodies correlated more strongly with neutralising antibodies (rs=0.7527; p<0.0001) than nucleocapsid antibodies (rs=0.3698; p<0.0001). A median of 24.4 weeks later, 58.2% (107/184) participants had nucleocapsid antibody seroreversion, compared to 20.9% (33/158) for RBD (p<0.001). Similar seroreversion rates were observed between staff and students for nucleocapsid (p = 0.26) and RBD-antibodies (p = 0.43). Nucleocapsid and RBD antibody quantitative results were significantly lower in staff compared to students (p = 0.028 and <0.0001 respectively) at baseline, but not at 24 weeks (p = 0.16 and p = 0.37, respectively). Interpretation: The immune response in children following SARS-CoV-2 infection was robust and sustained (>6 months) but further work is required to understand the extent to which this protects against reinfection. Funding: Department for Health and Social Care.

Original language	English
Article number	101150
Journal	EClinicalMedicine
Volume	41
DOIs	https://doi.org/10.1016/j.eclinm.2021.101150
Publication status	Published - Nov 2021

Bibliographical note

Funding Information:
Department for Health and Social Care. Applications for relevant anonymised data should be submitted to the Public Health England Office for Data Release: https://www.gov.uk/government/publications/accessing-public-health-england-data/about-the-phe-odr-and-accessing-data. The authors would like to thank the schools, headteachers, staff, families and their very brave children who took part in the sKIDs surveillance. The authors would also like to thank members of the Department for Education, Department of Health and Social Care, London School of Hygiene and Tropical medicine (LSHTM), Office for National Statistics (ONS) and the UK Scientific Advisory Group for Emergencies (SAGE) for their input and support for the sKIDs surveillance.

Publisher Copyright:
© 2021

Keywords

Antibody
SARS-CoV-2
School

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10.1016/j.eclinm.2021.101150

Cite this

Ireland, G., Jeffery-Smith, A., Zambon, M., Hoschler, K., Harris, R., Poh, J., Baawuah, F., Beckmann, J., Okike, I. O., Ahmad, S., Garstang, J., Brent, A. J., Brent, B., Aiano, F., Amin-Chowdhury, Z., Letley, L., Jones, S. E. I., Kall, M., Patel, M., ... Ladhani, S. N. (2021). Antibody persistence and neutralising activity in primary school students and staff: Prospective active surveillance, June to December 2020, England. EClinicalMedicine, 41, [101150]. https://doi.org/10.1016/j.eclinm.2021.101150

@article{36f3f5ec1e90479696d1ddedefd5ae33,

title = "Antibody persistence and neutralising activity in primary school students and staff: Prospective active surveillance, June to December 2020, England",

abstract = "Background: Prospective, longitudinal SARS-CoV-2 sero-surveillance in schools across England was initiated after the first national lockdown, allowing comparison of child and adult antibody responses over time. Methods: Prospective active serological surveillance in 46 primary schools in England tested for SARS-CoV-2 antibodies during June, July and December 2020. Samples were tested for nucleocapsid (N) and receptor binding domain (RBD) antibodies, to estimate antibody persistence at least 6 months after infection, and for the correlation of N, RBD and live virus neutralising activity. Findings: In June 2020, 1,344 staff and 835 students were tested. Overall, 11.5% (95%CI: 9.4–13.9) and 11.3% (95%CI: 9.2–13.6; p = 0.88) of students had nucleoprotein and RBD antibodies, compared to 15.6% (95%CI: 13.7–17.6) and 15.3% (95%CI: 13.4–17.3; p = 0.83) of staff. Live virus neutralising activity was detected in 79.8% (n = 71/89) of nucleocapsid and 85.5% (71/83) of RBD antibody positive children. RBD antibodies correlated more strongly with neutralising antibodies (rs=0.7527; p<0.0001) than nucleocapsid antibodies (rs=0.3698; p<0.0001). A median of 24.4 weeks later, 58.2% (107/184) participants had nucleocapsid antibody seroreversion, compared to 20.9% (33/158) for RBD (p<0.001). Similar seroreversion rates were observed between staff and students for nucleocapsid (p = 0.26) and RBD-antibodies (p = 0.43). Nucleocapsid and RBD antibody quantitative results were significantly lower in staff compared to students (p = 0.028 and <0.0001 respectively) at baseline, but not at 24 weeks (p = 0.16 and p = 0.37, respectively). Interpretation: The immune response in children following SARS-CoV-2 infection was robust and sustained (>6 months) but further work is required to understand the extent to which this protects against reinfection. Funding: Department for Health and Social Care.",

keywords = "Antibody, SARS-CoV-2, School",

author = "Georgina Ireland and Anna Jeffery-Smith and Maria Zambon and Katja Hoschler and Ross Harris and John Poh and Frances Baawuah and Joanne Beckmann and Okike, {Ifeanyichukwu O.} and Shazaad Ahmad and Joanna Garstang and Brent, {Andrew J.} and Bernadette Brent and Felicity Aiano and Zahin Amin-Chowdhury and Louise Letley and Jones, {Samuel E.I.} and Meaghan Kall and Monika Patel and Robin Gopal and Ray Borrow and Ezra Linley and Gayatri Amirthalingam and Brown, {Kevin E.} and Ramsay, {Mary E.} and Ladhani, {Shamez N.}",

note = "Funding Information: Department for Health and Social Care. Applications for relevant anonymised data should be submitted to the Public Health England Office for Data Release: https://www.gov.uk/government/publications/accessing-public-health-england-data/about-the-phe-odr-and-accessing-data. The authors would like to thank the schools, headteachers, staff, families and their very brave children who took part in the sKIDs surveillance. The authors would also like to thank members of the Department for Education, Department of Health and Social Care, London School of Hygiene and Tropical medicine (LSHTM), Office for National Statistics (ONS) and the UK Scientific Advisory Group for Emergencies (SAGE) for their input and support for the sKIDs surveillance. Publisher Copyright: {\textcopyright} 2021",

year = "2021",

month = nov,

doi = "10.1016/j.eclinm.2021.101150",

language = "English",

volume = "41",

journal = "EClinicalMedicine",

issn = "2589-5370",

publisher = "Elsevier",

}

Ireland, G, Jeffery-Smith, A, Zambon, M , Hoschler, K , Harris, R, Poh, J, Baawuah, F, Beckmann, J, Okike, IO, Ahmad, S, Garstang, J, Brent, AJ, Brent, B, Aiano, F, Amin-Chowdhury, Z , Letley, L, Jones, SEI, Kall, M , Patel, M , Gopal, R , Borrow, R , Linley, E , Amirthalingam, G , Brown, KE , Ramsay, ME & Ladhani, SN 2021, 'Antibody persistence and neutralising activity in primary school students and staff: Prospective active surveillance, June to December 2020, England', EClinicalMedicine, vol. 41, 101150. https://doi.org/10.1016/j.eclinm.2021.101150

TY - JOUR

T1 - Antibody persistence and neutralising activity in primary school students and staff

T2 - Prospective active surveillance, June to December 2020, England

AU - Ireland, Georgina

AU - Jeffery-Smith, Anna

AU - Zambon, Maria

AU - Hoschler, Katja

AU - Harris, Ross

AU - Poh, John

AU - Baawuah, Frances

AU - Beckmann, Joanne

AU - Okike, Ifeanyichukwu O.

AU - Ahmad, Shazaad

AU - Garstang, Joanna

AU - Brent, Andrew J.

AU - Brent, Bernadette

AU - Aiano, Felicity

AU - Amin-Chowdhury, Zahin

AU - Letley, Louise

AU - Jones, Samuel E.I.

AU - Kall, Meaghan

AU - Patel, Monika

AU - Gopal, Robin

AU - Borrow, Ray

AU - Linley, Ezra

AU - Amirthalingam, Gayatri

AU - Brown, Kevin E.

AU - Ramsay, Mary E.

AU - Ladhani, Shamez N.

N1 - Funding Information: Department for Health and Social Care. Applications for relevant anonymised data should be submitted to the Public Health England Office for Data Release: https://www.gov.uk/government/publications/accessing-public-health-england-data/about-the-phe-odr-and-accessing-data. The authors would like to thank the schools, headteachers, staff, families and their very brave children who took part in the sKIDs surveillance. The authors would also like to thank members of the Department for Education, Department of Health and Social Care, London School of Hygiene and Tropical medicine (LSHTM), Office for National Statistics (ONS) and the UK Scientific Advisory Group for Emergencies (SAGE) for their input and support for the sKIDs surveillance. Publisher Copyright: © 2021

PY - 2021/11

Y1 - 2021/11

N2 - Background: Prospective, longitudinal SARS-CoV-2 sero-surveillance in schools across England was initiated after the first national lockdown, allowing comparison of child and adult antibody responses over time. Methods: Prospective active serological surveillance in 46 primary schools in England tested for SARS-CoV-2 antibodies during June, July and December 2020. Samples were tested for nucleocapsid (N) and receptor binding domain (RBD) antibodies, to estimate antibody persistence at least 6 months after infection, and for the correlation of N, RBD and live virus neutralising activity. Findings: In June 2020, 1,344 staff and 835 students were tested. Overall, 11.5% (95%CI: 9.4–13.9) and 11.3% (95%CI: 9.2–13.6; p = 0.88) of students had nucleoprotein and RBD antibodies, compared to 15.6% (95%CI: 13.7–17.6) and 15.3% (95%CI: 13.4–17.3; p = 0.83) of staff. Live virus neutralising activity was detected in 79.8% (n = 71/89) of nucleocapsid and 85.5% (71/83) of RBD antibody positive children. RBD antibodies correlated more strongly with neutralising antibodies (rs=0.7527; p<0.0001) than nucleocapsid antibodies (rs=0.3698; p<0.0001). A median of 24.4 weeks later, 58.2% (107/184) participants had nucleocapsid antibody seroreversion, compared to 20.9% (33/158) for RBD (p<0.001). Similar seroreversion rates were observed between staff and students for nucleocapsid (p = 0.26) and RBD-antibodies (p = 0.43). Nucleocapsid and RBD antibody quantitative results were significantly lower in staff compared to students (p = 0.028 and <0.0001 respectively) at baseline, but not at 24 weeks (p = 0.16 and p = 0.37, respectively). Interpretation: The immune response in children following SARS-CoV-2 infection was robust and sustained (>6 months) but further work is required to understand the extent to which this protects against reinfection. Funding: Department for Health and Social Care.

AB - Background: Prospective, longitudinal SARS-CoV-2 sero-surveillance in schools across England was initiated after the first national lockdown, allowing comparison of child and adult antibody responses over time. Methods: Prospective active serological surveillance in 46 primary schools in England tested for SARS-CoV-2 antibodies during June, July and December 2020. Samples were tested for nucleocapsid (N) and receptor binding domain (RBD) antibodies, to estimate antibody persistence at least 6 months after infection, and for the correlation of N, RBD and live virus neutralising activity. Findings: In June 2020, 1,344 staff and 835 students were tested. Overall, 11.5% (95%CI: 9.4–13.9) and 11.3% (95%CI: 9.2–13.6; p = 0.88) of students had nucleoprotein and RBD antibodies, compared to 15.6% (95%CI: 13.7–17.6) and 15.3% (95%CI: 13.4–17.3; p = 0.83) of staff. Live virus neutralising activity was detected in 79.8% (n = 71/89) of nucleocapsid and 85.5% (71/83) of RBD antibody positive children. RBD antibodies correlated more strongly with neutralising antibodies (rs=0.7527; p<0.0001) than nucleocapsid antibodies (rs=0.3698; p<0.0001). A median of 24.4 weeks later, 58.2% (107/184) participants had nucleocapsid antibody seroreversion, compared to 20.9% (33/158) for RBD (p<0.001). Similar seroreversion rates were observed between staff and students for nucleocapsid (p = 0.26) and RBD-antibodies (p = 0.43). Nucleocapsid and RBD antibody quantitative results were significantly lower in staff compared to students (p = 0.028 and <0.0001 respectively) at baseline, but not at 24 weeks (p = 0.16 and p = 0.37, respectively). Interpretation: The immune response in children following SARS-CoV-2 infection was robust and sustained (>6 months) but further work is required to understand the extent to which this protects against reinfection. Funding: Department for Health and Social Care.

KW - Antibody

KW - SARS-CoV-2

KW - School

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U2 - 10.1016/j.eclinm.2021.101150

DO - 10.1016/j.eclinm.2021.101150

M3 - Article

AN - SCOPUS:85122654833

SN - 2589-5370

VL - 41

JO - EClinicalMedicine

JF - EClinicalMedicine

M1 - 101150

ER -

Antibody persistence and neutralising activity in primary school students and staff: Prospective active surveillance, June to December 2020, England

Abstract

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