• Emily Lowthian, Hoda Abbasizanjani, Stuart Bedston, Ashley Akbari, Laura Cowley, Richard Fry, Rhiannon K Owen, Joe Hollinghurst, Igor Rudan, Jillian Beggs, Emily Marchant, Fatemeh Torabi, LusignanSimon deSNuffield Department of Primary Care Health Sciences, University of Oxford, OX2 6GG, UK., Tom Crick, Graham Moore, Aziz Sheikh, and Ronan A Lyons.
• Population Data Science, Swansea University Medical School, Faculty of Medicine, Health and Life Science, Swansea University, SA2 8PP, UK.
• J R Soc Med. 2023 Dec 1; 116 (12): 413424413-424.

ObjectivesWe investigated SARS-CoV-2 infection trends, risk of SARS-CoV-2 infection and COVID-19 vaccination uptake among school staff, students and their household members in Wales, UK.DesignSeven-day average of SARS-CoV-2 infections and polymerase chain reaction tests per 1000 people daily, cumulative incidence of COVID-19 vaccination uptake and multi-level Poisson models with time-varying covariates.SettingNational electronic cohort between September 2020 and May 2022 when several variants were predominant in the UK (Alpha, Delta and Omicron).ParticipantsSchool students aged 4 to 10/11 years (primary school and younger middle school, n = 238,163), and 11 to 15/16 years (secondary school and older middle school, n = 182,775), school staff in Wales (n = 47,963) and the household members of students and staff (n = 697,659).Main Outcome MeasuresSARS-CoV-2 infection and COVID-19 vaccination uptake.ResultsSchool students had a sustained period of high infection rates compared with household members after August 2021. Primary schedule vaccination uptake was highest among staff (96.3%) but lower for household members (72.2%), secondary and older middle school students (59.8%), and primary and younger middle school students (3.3%). Multi-level Poisson models showed that vaccination was associated with a lower risk of SARS-CoV-2 infection. The Delta variant posed a greater infection risk for students than the Alpha variant. However, Omicron was a larger risk for staff and household members.ConclusionsPublic health bodies should be informed of the protection COVID-19 vaccines afford, with more research being required for younger populations. Furthermore, schools require additional support in managing new, highly transmissible variants. Further research should examine the mechanisms between child deprivation and SARS-CoV-2 infection.

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