Coronavirus STORY (Serum Testing of Representative Youngsters)
Lead Research Organisation:
University of Oxford
Department Name: UNLISTED
Abstract
An important way of tracking the spread of a new viruses like the novel coronavirus
(COVID-19) is to study the blood-born immunity against that virus in the general
population.
Measuring this at the beginning of an outbreak can determine what proportion (if any) of
the population already have immunity, and ongoing monitoring for any increase in this
proportion can show how many people are getting new infections.
This is especially important for children, who are often responsible for spreading
respiratory infections to others.
Accordingly, Public Health England plan to study the concentrations of antibodies (a
marker of immunity) against COVID-19 in 400 children and teenagers per month for the
duration of the COVID-19 outbreak.
(COVID-19) is to study the blood-born immunity against that virus in the general
population.
Measuring this at the beginning of an outbreak can determine what proportion (if any) of
the population already have immunity, and ongoing monitoring for any increase in this
proportion can show how many people are getting new infections.
This is especially important for children, who are often responsible for spreading
respiratory infections to others.
Accordingly, Public Health England plan to study the concentrations of antibodies (a
marker of immunity) against COVID-19 in 400 children and teenagers per month for the
duration of the COVID-19 outbreak.
Technical Summary
"This COVID-19 Rapid Response award is jointly funded (50:50) between the Medical Research Council and the National Institute for Health Research. The figure displayed is the total award amount of the two funders combined, with each partner contributing equally towards the project.
This COVID-19 paediatric sero-epidemiology study will adapt an existing national research
network and ethically-approved NIHR-funded study to collect sufficient childhood and
teenage serum samples for near real-time monitoring of increases in paediatric COVID-19
sero-positivity rates across the UK in 2020.
The importance of sero-epidemiological monitoring is emphasised in the Public Health
England (PHE) pandemic influenza protocol, currently being adapted in response to the
COVID-19 threat. This requires the monthly collection of 1000 serum samples, including
100 per month in each of the 0-4, 5-9, 10-14 and 15-19 year old age-groups. This is
essential to understanding the rates of symptomatic and asymptomatic infection in
children, a population that are the predominant transmitters of most respiratory viruses.
This information is in turn crucial to understanding the severity of COVID-19 disease in
children, as well as modelling the spread of this virus through the community and planning
an effective public health response.
The challenge of obtaining blood samples from representative cohorts of children (rather
than residual sera from sampling for clinical purposes) had already led to the Oxford
Vaccine Group (OVG), PHE and seven regional partners throughout England establishing
the ‘What’s the STORY (Serum Testing of Representative Youngsters)’ network to
evaluate antibody levels against vaccine-preventable diseases. This study has
commenced, and with additional funding would be expanded to collect 3200 samples
throughout 2020, including collection of individual level information on recent respiratory
illnesses and relevant medical history. Further extension would be possible if needed with
appropriate resourcing. This study will form a rapid, responsive and crucial component of
the UK response to this emerging global threat."
This COVID-19 paediatric sero-epidemiology study will adapt an existing national research
network and ethically-approved NIHR-funded study to collect sufficient childhood and
teenage serum samples for near real-time monitoring of increases in paediatric COVID-19
sero-positivity rates across the UK in 2020.
The importance of sero-epidemiological monitoring is emphasised in the Public Health
England (PHE) pandemic influenza protocol, currently being adapted in response to the
COVID-19 threat. This requires the monthly collection of 1000 serum samples, including
100 per month in each of the 0-4, 5-9, 10-14 and 15-19 year old age-groups. This is
essential to understanding the rates of symptomatic and asymptomatic infection in
children, a population that are the predominant transmitters of most respiratory viruses.
This information is in turn crucial to understanding the severity of COVID-19 disease in
children, as well as modelling the spread of this virus through the community and planning
an effective public health response.
The challenge of obtaining blood samples from representative cohorts of children (rather
than residual sera from sampling for clinical purposes) had already led to the Oxford
Vaccine Group (OVG), PHE and seven regional partners throughout England establishing
the ‘What’s the STORY (Serum Testing of Representative Youngsters)’ network to
evaluate antibody levels against vaccine-preventable diseases. This study has
commenced, and with additional funding would be expanded to collect 3200 samples
throughout 2020, including collection of individual level information on recent respiratory
illnesses and relevant medical history. Further extension would be possible if needed with
appropriate resourcing. This study will form a rapid, responsive and crucial component of
the UK response to this emerging global threat."
Publications
Ratcliffe H
(2023)
Community seroprevalence of SARS-CoV-2 in children and adolescents in England, 2019-2021
in Archives of Disease in Childhood
| Description | Understanding what proportion of children and adolescents have had a SARS-CoV-2 infection |
| Geographic Reach | National |
| Policy Influence Type | Contribution to a national consultation/review |
| Impact | These data have been crucial to understanding what proportion of children/adolescents remained at risk of SARS-CoV-2 infection through 2021, which in turn is vital for policy on immunisation, school closures and infection prevention measures in school. |
| Title | STORY (Serum testing of representative youngsters) - serum biobank |
| Description | The STORY study was initiall set up as a pliot study to create a store of sera, in order to determine the concentration of antibodies against vaccine preventable diseases in English children and adolescents. Following the onset of the COVID-19 pandemic this was adapted for testing of against SARS-COV-2. In the course of this study we have obtained over 3500 serum samples from nearly 3000 young people aged 0 to 24 years taken from all regions of England, with extensive information on demographics (age, ethnicity, socie-economic status) and vaccination history. This unique dataset is available as a public resource, with priority given to requests from Public Health England/UK Health Security Agency. This resource is currently being used for testing of antibodies against diphtheria and capsular group C meningococcus (MenC). |
| Type Of Material | Database/Collection of data |
| Year Produced | 2020 |
| Provided To Others? | Yes |
| Impact | Testing is currently underway for antibodies against dptheria and group C meningococcus in light of limited outbreaks of these diseases, to determine if there are deficiencies in vaccine induced protection against these diseases in any particular geographic region or age group. |
| Description | COVID-warriors |
| Organisation | Queen's University Belfast |
| Country | United Kingdom |
| Sector | Academic/University |
| PI Contribution | COVID-warriors is a paediatric seroprevalence study conducted in the children of healthcare workers that acts as a companion to STORY. The datasets from these two studies have been pooled for an analysis of the kinetics of antibody decline after SARS-COV-2 infection in children and adolescents, and cross protective immunity following seasonal coronavirus infections. |
| Collaborator Contribution | COVID-warriors is a paediatric seroprevalence study conducted in the children of healthcare workers that acts as a companion to STORY. The datasets from these two studies have been pooled for an analysis of the kinetics of antibody decline after SARS-COV-2 infection in children and adolescents, and cross protective immunity following seasonal coronavirus infections. |
| Impact | The results from this anlaysis are currently being prepared for publication. |
| Start Year | 2020 |
| Description | UK Coronavirus Immunology Consortium (UK CIC) |
| Organisation | University of Birmingham |
| Country | United Kingdom |
| Sector | Academic/University |
| PI Contribution | The Coronavirus STORY study has made over 3000 serum samples taken from community sampling of children and adolescents during the COVID-19 pandemic for testing, along with PBMC samples from over 100 participants to assess cellular immunity to SARS-CoV-2 and seasonal corinaviruses in this population. These have covered both seropositive and seronegative individuals. |
| Collaborator Contribution | An Oxford based member of the UKCIC consortium (Prof Susie Dunachie) and her team have evaluated T cell immunity to SARS-CoV2 and seaonal corinaviruses, demonstrating that relatively few SARS-CoV-2 sero-negative children display any evidence of T cell immunity against SARS=CoV-2, i.e. there is not a high proportion whose SRARS-COV02 infections are being 'missed' by serology. There is also little evidence of immunity against cross-reactive immunity with seasonal coronavirus in this population. |
| Impact | These data are currently being prepared for publication. |
| Start Year | 2020 |
| Description | UK HSA |
| Organisation | Public Health England |
| Country | United Kingdom |
| Sector | Public |
| PI Contribution | This project was undertaken with Public Health England, in which the STORY team conducted a pliot seroprevalence study to obtain serum samples from a representative cross-section of the English paediatric/adolescent population. Samples were provided to the laboratories of PHE Colindale (via the PHE sero-epidemiology unit) for testing , and the results analysed by members of the Oxford Vaccine Group. |
| Collaborator Contribution | Public Health England provided input into the initial study design, tested the samples and have contribiuted to the interpretation of results. |
| Impact | The results of the STORY seroprevelance study have been presented to the World Health Organisation and included in UK SAGE reports from PHE, informing consideration of the proportion of UK children and adolescents who have experienced a SARS-CoV-2 infection. The enhanced recruitment of participants from BAME communities provided definitive evidence of the increased risk in this population, independent of socio-economic status. |
| Start Year | 2020 |
| Description | Engagement with BAME communities |
| Form Of Engagement Activity | Engagement focused website, blog or social media channel |
| Part Of Official Scheme? | No |
| Geographic Reach | National |
| Primary Audience | Public/other audiences |
| Results and Impact | During an interim analysis from What's the STORY in August 2020 a picture of increased risk of seropositivity for SARS-CoV-2 in minority ethnic groups was noted within the paediatric population. To examine ethnicity as a risk factor, efforts to enhance recruitment of children from minority ethnic groups was undertaken. Each site used established local contacts to reach out to minority communities in their regions. Other methods included direct mail outs/SMS through NHS databases who kept ethnicity on record, pharmacies in areas with high proportions of the population of interest, and targeted social media adverts. Study information was adapted with a direct plea to the communities of interest. This increased the total percentage of participants from minority ethnic groups to 17% with just under half of our participants in our final time period belonging to a minority ethnic group. |
| Year(s) Of Engagement Activity | 2020,2021 |
| URL | https://www.whatsthestory.org.uk/home |