Studies conducted before mass vaccination campaigns began have reported proper and consistent facemasking by students and staff in school settings are associated with reduced incidence of school-associated transmission or seropositivity.
Fewer studies have reported efficacy of facemasking in the post-mass vaccination period in school settings. The studies available report, however, school-associated transmission were lower, less than 1% secondary attack rate in schools.
Studies of school-associated COVID-19 cases find community exposure to SARS-CoV-2 and/or noncompliance with multiple mitigation measures (e.g. facemask policies, distancing, non-isolation, etc) are key factors of clusters and outbreaks in children.
Badea, A; Groot, G; Muhajarine, N; Howell-Spooner, B; Young, C. What is the evidence for the effectiveness of universal mask use in the pediatric population? 2021 Sep 30, Document no.: EOC210901 RR. In: COVID-19 Rapid Evidence Reviews [Internet]. SK: SK COVID Evidence Support Team, c2021. 14 p. (CEST rapid review report).
Howell-Spooner, B., Young, C.. What is the evidence for the effectiveness of universal mask use in the pediatric population?? 2021 Sep 28, Document no.: EOC210901 ESR. In: COVID-19 Rapid Evidence Reviews [Internet]. SK: SK COVID Evidence Support Team, c2021. 25 p. (CEST rapid review report).
AUGUST 7th UPDATE: No new studies examining secondary attack rates of pediatric index cases were found. Studies continue to suggest low transmission from pediatric cases, and high proportion of pediatric cases being asymptomatic to mildly symptomatic.
Key Findings
· Pediatric cases of COVID-19 constitute between 1% to 10% of all confirmed cases of COVID-19; variation exists by jurisdiction.
· Few case reports exist of confirmed child-to-other transmission. Contact tracing studies suggest that children are unlikely to be transmitters of the disease. Households are the most likely environments for transmission.
· A recent large South Korean contact tracing study however (in pre-print) found that household COVID-19 transmission rates for children age 10-19 were significantly higher than in adults; transmission rates for children age 0-9 were relatively low.
Sulaiman, F; Groot, G; Muhajarine, N; Dalidowicz, M; Miller, L. What is the transmissibility and epidemiology of COVID-19 in children and adolescents? 2020 Aug 14; Document no.: EOC070201v2 RR. In: COVID-19 Rapid Evidence Reviews [Internet]. SK: SK COVID Evidence Support Team, c2020. 12 p. (CEST rapid review report)
Dalidowicz, M; Ellsworth, C. What is the transmissibility and epidemiology of COVID-19 in children and adolescents? 2020 Aug 7; Document no.: EOC070201v2-01 ESR. In: COVID-19 Rapid Evidence Reviews [Internet]. SK: SK COVID Evidence Support Team, c2020. 29 p. (CEST evidence search report)
