Project #54:
Association between living with children and outcomes from COVID-19: an update of an OpenSAFELY cohort study in England

COVID-19 disease in children and young people is typically mild or asymptomatic, however the role of children and young people in transmission of SARs-CoV-2 remains unclear. At the start of the COVID-19 pandemic, schools were shut, on the premise that children may be vectors of COVID-19, as they are for other respiratory diseases, such as seasonal influenza. Evidence on the absolute impacts of educational settings being closed on community transmission is mixed; quantifying the impact is challenging, as closures have been implemented alongside other public health measures, infection control measures vary across educational settings and school opening may be associated with other behavioural changes. The negative impacts of school closures on the educational, developmental and mental health of children is undisputed.

In our previous analysis we showed during the first wave of the UK pandemic, when schools were largely closed, for adults 65 years and under living with children there was no evidence of a markedly increased risk of SARS-CoV-2 infection or severe COVID-19 outcomes. However, during wave 2 (1st September to 19th December 2020) when schools were largely open, there was evidence of increased risk of infection and hospitalisation with COVID-19, although the risk of death from COVID-19 was not increased in either wave.

In this analysis, we examine the risk of SARS-CoV-2 infection and outcomes from COVID-19 associated with living with children compared to those without during 2021, and the impact that adult vaccination had on that risk.