key: cord-0846809-w89avkjl
authors: Bird, Paul W.; Riff, Roger; Folwell, Andrew; Holmes, Christopher W.; Tang, Julian W.
title: Increased incidence of COVID‐19 in younger patients (May–July 2021)—An argument for extending vaccination?
date: 2021-10-06
journal: J Med Virol
DOI: 10.1002/jmv.27363
sha: 2881a54d7722fffa031a149f6862fe93f737ada3
doc_id: 846809
cord_uid: w89avkjl

The decision on whether or not to vaccinate young children against COVID-19 is causing significant controversy in the UK This article is protected by copyright. All rights reserved.

Increased incidence of COVID-19 in younger patients (May-July 2021)-An argument for extending vaccination?

To the Editor, The decision on whether or not to vaccinate young children against coronavirus disease 2019 (COVID-19) is causing significant controversy in the UK. Ladhani 1 outlines the pros and cons of vaccinating school children, and we agree that it is not an easy decision. However, with a potentially difficult winter ahead, including the backlog of non-COVID-19 medical cases to care for and the return of seasonal respiratory viruses in the absence of COVID-19 restrictions, 2 expanding vaccine coverage for both influenza and COVID-19, would seem prudent. Another aspect that needs to be considered is the impact that increased numbers of sick children (even if not requiring hospitalization) will have on working parents, who will need to take time off work to care for them.

Although the COVID-19 vaccine rollout in the UK has been a remarkable success, the last phase of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) versus vaccine race is being hampered by a reduced vaccine uptake in the younger population (18-30 years old). This is likely due to individual risk-benefit selfassessment, based on some widely publicized data, 3 Unfortunately, what these low vaccine update figures do not show is the potential impact on the older adult contacts of these potentially delta variant-infected younger populations (e.g., parents, grandparents, teachers), where the delta variant has effectively broken through fully vaccinated individuals, some of whom need hospitalization. 4, 5 The increasing numbers of hospitalized cases infected with the delta variant are likely partly due to some degree of the waning of vaccine immunity over time. 6, 7 Not only this, a recent US study has suggested that delta variant SARS-COV-2 viral loads are similar between newly diagnosed COVID-19 cases that have been vaccinated (mainly with the messenger RNA vaccines) and the unvaccinated, 8 indicating that even fully vaccinated adults can potentially still transmit the virus to unvaccinated children.

Local data (Table and Figure 1 ), during May-July 2021, confirm this UK trend of a higher incidence of hospitalized COVID-19 cases in the younger population, in whom vaccine coverage is generally lower. Table 1 shows increasing numbers of COVID-19 cases presenting to hospital-now mostly due to the delta variant 9 -in the younger groups, but also in the more vulnerable older adult and elderly populations. Yet, although the absolute numbers of COVID-19 cases are rising in these populations, COVID-19 cases are rising at similar rates across all the age groups, so the overall proportion of COVID-19 cases across these different age groups remains more or less con- Abbreviations: PCR, polymerase chain reaction; SARS-CoV-2, severe acute respiratory syndrome coronavirus 2; UHL, University Hospitals of Leicester.

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