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  1. Article ; Online: Age-Varying Susceptibility to the Delta Variant (B.1.617.2) of SARS-CoV-2.

    Chun, June Young / Jeong, Hwichang / Kim, Yongdai

    JAMA network open

    2022  Volume 5, Issue 3, Page(s) e223064

    Abstract: Importance: The Delta variant (B.1.617.2) is estimated to be more transmissible than previous strains of SARS-CoV-2, especially among children and adolescents. However, to our knowledge, there are no reports confirming this to date.: Objective: To ... ...

    Abstract Importance: The Delta variant (B.1.617.2) is estimated to be more transmissible than previous strains of SARS-CoV-2, especially among children and adolescents. However, to our knowledge, there are no reports confirming this to date.
    Objective: To gain a better understanding of the association of age with susceptibility to the Delta variant of SARS-CoV-2.
    Design, setting, and participants: This decision analytic model used an age-structured compartmental model using the terms symptom onset (S), exposure (E), infectious (I), and quarantine (Q) (SEIQ) to estimate the age-specific force of infection, combining age-specific contact matrices and observed distribution of periods between each stage of infection (E to I [ie, latent period], I given S, and S to Q [ie, diagnostic delay]) developed in a previous contact tracing study. A bayesian inference method was used to estimate the age-specific force of infection (S to E) and, accordingly, age-specific susceptibility. The age-specific susceptibility during the third wave (ie, before Delta, from October 15 to December 22, 2020, when the COVID-19 vaccination campaign was not yet launched) and the fourth wave (ie, the Delta-driven wave, from June 27 to August 21, 2021) in Korea were compared. As vaccine uptake increased, individuals who were vaccinated were excluded from the susceptible population in accordance with vaccine effectiveness against the Delta variant. This nationwide epidemiologic study included individuals who were diagnosed with COVID-19 during the study period in Korea. Data were analyzed from September to November 2021.
    Exposures: Age group during the third wave (ie, before Delta) and fourth wave (ie, Delta-driven) of the COVID-19 pandemic in South Korea.
    Main outcomes and measures: Age-specific susceptibility during the third and fourth waves was estimated.
    Results: Among 106 866 confirmed COVID-19 infections (including 26 597 infections and 80 269 infections during the third and fourth waves of COVID-19 in Korea, respectively), a significant difference in age-specific susceptibility to the Delta vs pre-Delta variant was found in the younger age group. After adjustment for contact pattern and vaccination status, the increase in susceptibility to the Delta vs pre-Delta variant was estimated to be highest in the group aged 10 to 15 years, approximately doubling (1.92-fold increase [95% CI, 1.86-fold to 1.98-fold]), whereas in the group aged 50 years or more, susceptibility to the Delta vs pre-Delta variant remained stable at an approximately 1-fold change (eg, among individuals aged 50-55 years: 0.997-fold [95% CI, 0.989-fold to 1.001-fold).
    Conclusions and relevance: In this study, the Delta variant of SARS-CoV-2 was estimated to propagate more easily among children and adolescents than pre-Delta strains, even after adjusting for contact pattern and vaccination status.
    MeSH term(s) Adolescent ; Bayes Theorem ; COVID-19/epidemiology ; COVID-19 Vaccines ; Child ; Delayed Diagnosis ; Humans ; Middle Aged ; Pandemics ; SARS-CoV-2
    Chemical Substances COVID-19 Vaccines
    Language English
    Publishing date 2022-03-01
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ISSN 2574-3805
    ISSN (online) 2574-3805
    DOI 10.1001/jamanetworkopen.2022.3064
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Identifying susceptibility of children and adolescents to the Omicron variant (B.1.1.529).

    Chun, June Young / Jeong, Hwichang / Kim, Yongdai

    BMC medicine

    2022  Volume 20, Issue 1, Page(s) 451

    Abstract: Background: The Omicron variant (B.1.1.529) is estimated to be more transmissible than previous strains of SARS-CoV-2 especially among children, potentially resulting in croup which is a characteristic disease in children. Current coronavirus disease ... ...

    Abstract Background: The Omicron variant (B.1.1.529) is estimated to be more transmissible than previous strains of SARS-CoV-2 especially among children, potentially resulting in croup which is a characteristic disease in children. Current coronavirus disease 2019 (COVID-19) cases among children might be higher because (i) school-aged children have higher contact rates and (ii) the COVID-19 vaccination strategy prioritizes the elderly in most countries. However, there have been no reports confirming the age-varying susceptibility to the Omicron variant to date.
    Methods: We developed an age-structured compartmental model, combining age-specific contact matrix in South Korea and observed distribution of periods between each stage of infection in the national epidemiological investigation. A Bayesian inference method was used to estimate the age-specific force of infection and, accordingly, age-specific susceptibility, given epidemic data during the third (pre-Delta), fourth (Delta driven), and fifth (Omicron driven) waves in South Korea. As vaccine uptake increased, individuals who were vaccinated were excluded from the susceptible population in accordance with vaccine effectiveness against the Delta and Omicron variants, respectively.
    Results: A significant difference between the age-specific susceptibility to the Omicron and that to the pre-Omicron variants was found in the younger age group. The rise in susceptibility to the Omicron/pre-Delta variant was highest in the 10-15 years age group (5.28 times [95% CI, 4.94-5.60]), and the rise in susceptibility to the Omicron/Delta variant was highest in the 15-19 years age group (3.21 times [95% CI, 3.12-3.31]), whereas in those aged 50 years or more, the susceptibility to the Omicron/pre-Omicron remained stable at approximately twofold.
    Conclusions: Even after adjusting for contact pattern, vaccination status, and waning of vaccine effectiveness, the Omicron variant of SARS-CoV-2 tends to propagate more easily among children than the pre-Omicron strains.
    MeSH term(s) Child ; Adolescent ; Humans ; Aged ; Young Adult ; Adult ; COVID-19/epidemiology ; COVID-19/prevention & control ; Bayes Theorem ; COVID-19 Vaccines ; SARS-CoV-2/genetics
    Chemical Substances COVID-19 Vaccines
    Language English
    Publishing date 2022-11-23
    Publishing country England
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 2131669-7
    ISSN 1741-7015 ; 1741-7015
    ISSN (online) 1741-7015
    ISSN 1741-7015
    DOI 10.1186/s12916-022-02655-z
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Contact-adjusted Immunity Levels against SARS-CoV-2 in Korea and Prospects for Achieving Herd Immunity.

    Chun, June Young / Jeong, Hwichang / Kim, Yongdai

    Journal of Korean medical science

    2021  Volume 36, Issue 38, Page(s) e272

    Abstract: The proportion of population vaccinated cannot be directly translated into the herd immunity. We have to account for the age-stratified contact patterns to calculate the population immunity level, since not every individual gathers evenly. Here, we ... ...

    Abstract The proportion of population vaccinated cannot be directly translated into the herd immunity. We have to account for the age-stratified contact patterns to calculate the population immunity level, since not every individual gathers evenly. Here, we calculated the contact-adjusted population immunity against severe acute respiratory syndrome coronavirus 2 in South Korea using age-specific incidence and vaccine uptake rate. We further explored options to achieve the theoretical herd immunity with age-varying immunity scenarios. As of June 21, 2021, when a quarter of the population received at least one dose of a coronavirus disease 2019 (COVID-19) vaccine, the contact-adjusted immunity level was 12.5% under the social distancing level 1. When 80% of individuals aged 10 years and over gained immunity, we could achieve a 58.2% contact-adjusted immunity level. The pros and cons of vaccinating children should be weighed since the risks of COVID-19 for the young are less than the elderly, and the long-term safety of vaccines is still obscure.
    MeSH term(s) COVID-19/immunology ; COVID-19/prevention & control ; COVID-19 Vaccines/immunology ; Humans ; Immunity, Herd/immunology ; Mass Vaccination ; Republic of Korea ; SARS-CoV-2/immunology ; Social Interaction
    Chemical Substances COVID-19 Vaccines
    Language English
    Publishing date 2021-10-04
    Publishing country Korea (South)
    Document type Journal Article
    ZDB-ID 639262-3
    ISSN 1598-6357 ; 1011-8934
    ISSN (online) 1598-6357
    ISSN 1011-8934
    DOI 10.3346/jkms.2021.36.e272
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: COVID-19 Vaccine Prioritisation in Japan and South Korea

    Chun, June Young / Jeong, Hwichang / Beutels, Philippe / Ohmagari, Norio / Kim, Yongdai / Tsuzuki, Shinya

    medRxiv

    Abstract: Background Due to a limited initial supply of COVID-19 vaccines, the prioritisation of individuals for vaccination is of utmost importance for public health. Here, we provide the optimal allocation strategy for COVID-19 vaccines according to age in Japan ...

    Abstract Background Due to a limited initial supply of COVID-19 vaccines, the prioritisation of individuals for vaccination is of utmost importance for public health. Here, we provide the optimal allocation strategy for COVID-19 vaccines according to age in Japan and South Korea. Methods Combining national case reports, age-specific contact matrices, and observed periods between each stages of infection (Susceptible-Exposed-Infectious-Quarantined), we constructed a compartmental model. We estimated the age-stratified probability of transmission given contact (q_i) using Bayesian inference method and simulated different vaccination scenarios to reduce either case numbers or death toll. We also performed sensitivity analyses on the proportion of asymptomatic cases and vaccine efficacy. Findings The model inferred age-stratified probability of transmission given contact (q_i) showed similar age-dependent increase in Japan and South Korea. Assuming the reported COVID-19 vaccine efficacy, our results indicate that Japan and South Korea need to prioritise individuals aged 20-35 years and individuals aged over 60 years, respectively, to minimise case numbers. To minimise the death toll, both countries need to prioritise individuals aged over 75 years. These trends were not changed by proportions of asymptomatic cases and varying vaccine efficacy on individuals under 20 years. Interpretation We presented the optimal vaccination strategy for Japan and South Korea. Comparing the results of these countries demonstrates that not only the effective contact rates containing q_i but also the age-demographics of current epidemic in Japan (dominance in 20s) and South Korea (dominant cases over 50s) affect vaccine allocation strategy.
    Keywords covid19
    Language English
    Publishing date 2021-04-20
    Publisher Cold Spring Harbor Laboratory Press
    Document type Article ; Online
    DOI 10.1101/2021.04.16.21255649
    Database COVID19

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