87 - SARS-CoV-2 Antibody Prevalence Among Unvaccinated Children in New Jersey

Reopening schools and lifting masking and distancing mandates across New Jersey (NJ) has increased COVID-19 transmission among children in the state. While children are frequently exposed to SARS-CoV-2, they are least likely to be vaccinated against the virus. Little is known about SARS-CoV-2 antibody prevalence in children.

Objective: We examined SARS-CoV-2 antibody prevalence in unvaccinated NJ children and evaluated the role of household vaccination status.

Design/Methods: Unvaccinated children aged 18 months to 11 years had oral fluid antibody tests for SARS-CoV-2 and their caregivers completed electronic surveys at two clinic-based practices in Northern and Central NJ from August 2022 to December 2022. Antibody results were compared to survey responses. Information was collected on household exposures, family vaccination status, COVID-19-related illness, and beliefs about pediatric vaccination.

Results: A total of 480 children submitted oral swabs and a corresponding survey. Respondents were 55% male, predominantly non-Hispanic Black (39%) or Hispanic/Latino (37%), and on average, 5.6 years old. Antibody positivity of this sample was 65%. Of those, 31% (n=94) reported ever having been diagnosed with COVID-19, and less than half sought care for their symptoms. Of those reporting exposure to COVID-19 (n=182, 38%), 77% reported exposure in the household. The majority (69%) of children were from households with at least one fully vaccinated adult. Families of antibody-positive children had a significantly lower proportion of fully vaccinated adults in the household compared to antibody-negative children (p< 0.05).
While 68% (n=312) of caregivers felt the vaccine was at least somewhat effective in preventing disease, only 25% planned to vaccinate their child against COVID-19 in the next 6 months. Those from households with at least one vaccinated adult were significantly more likely to plan to vaccinate their child than those with no vaccinated adults (33% vs 7%, p< 0.001); this proportion increased with each additional vaccinated adult in the household.

Conclusion(s): Overall antibody positivity in this sample is nearly double the proportion diagnosed with COVID-19. Despite the prevalence of household COVID-19 exposures, caregiver vaccination status, and caregiver understanding of the beneficial role of vaccination in preventing disease, the majority of caregivers do not plan to vaccinate their children. Increasing vaccine acceptance among parents and other adults may provide opportunities to increase uptake of pediatric vaccinations over time.