Prevalence of SARS-CoV-2 Infection among Children and Adults in 15 US Communities, 2021

Abstract

During January-August 2021, the Community Prevalence of SARS-CoV-2 Study used time/location sampling to recruit a cross-sectional, population-based cohort to estimate SARS-CoV-2 seroprevalence and nasal swab sample PCR positivity across 15 US communities. Survey-weighted estimates of SARS-CoV-2 infection and vaccine willingness among participants at each site were compared within demographic groups by using linear regression models with inverse variance weighting. Among 22,284 persons >2 months of age and older, median prevalence of infection (prior, active, or both) was 12.9% across sites and similar across age groups. Within each site, average prevalence of infection was 3 percentage points higher for Black than White persons and average vaccine willingness was 10 percentage points lower for Black than White persons and 7 percentage points lower for Black persons than for persons in other racial groups. The higher prevalence of SARS-CoV-2 infection among groups with lower vaccine willingness highlights the disparate effect of COVID-19 and its complications.

Keywords: 2019 novel coronavirus disease; COVID-19; SARS-CoV-2; United States; community surveys; coronavirus disease; epidemiology; respiratory infections; severe acute respiratory syndrome coronavirus 2; surveys and questionnaires; time/location sampling; viruses; zoonoses.

Figure 1

Participant enrollment from community venues in study of prevalence of SARS-CoV-2 infection among children and adults in 15 US communities (COMPASS 2021). Each site completed community enrollment from a median of 30 (interquartile range 24–35) venues. At each site, 80% of community enrollments were completed at a median of 13 (interquartile range 8.5–15.5) venues. DBS, dried blood spot.

Figure 2

Demographic characteristics of community cohort (n = 21,189) in study of prevalence of SARS-CoV-2 infection among children and adults in 15 US communities (COMPASS 2021) and the 2020 US Census American Community Survey (https://www.census.gov/programs-surveys/acs) for each site.

Figure 3

Prevalence of active or prior COVID-19 infection in 15 US communities, community cohort (n = 21,189), COMPASS 2021. A) By demographic characteristic across all sites. B) By age and site. Error bars indicate interquartile ranges. Note: Analysis of age limited to communities with >25 children who had complete data.

Figure 4

Prevalence of COVID-19 vaccine willingness in 15 US communities, by demographic characteristics, all sites, community cohort, COMPASS 2021. Note: Analysis of age limited to communities with >25 children who had complete data.