Assessing the role of children in the COVID-19 pandemic in Belgium using perturbation analysis

Leonardo Angeli (), Constantino Pereira Caetano, Nicolas Franco, Pietro Coletti, Christel Faes, Geert Molenberghs, Philippe Beutels, Steven Abrams, Lander Willem and Niel Hens
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Leonardo Angeli: Hasselt University
Constantino Pereira Caetano: Instituto Superior Técnico, University of Lisbon
Nicolas Franco: Hasselt University
Pietro Coletti: Hasselt University
Christel Faes: Hasselt University
Geert Molenberghs: Hasselt University
Philippe Beutels: Vaccine & Infectious Disease Institute, University of Antwerp
Steven Abrams: Hasselt University
Lander Willem: Vaccine & Infectious Disease Institute, University of Antwerp
Niel Hens: Hasselt University

Nature Communications, 2025, vol. 16, issue 1, 1-14

Abstract: Abstract Understanding the evolving role of different age groups in virus transmission is essential for effective pandemic management. We investigated SARS-CoV-2 transmission in Belgium from November 2020 to February 2022, focusing on age-specific patterns. Using a next generation matrix approach integrating social contact data and simulating population susceptibility evolution, we performed a longitudinal perturbation analysis of the effective reproduction number to unravel age-specific transmission dynamics. From November to December 2020, adults in the [18, 60) age group were the main transmission drivers, while children contributed marginally. This pattern shifted between January and March 2021, when in-person education resumed, and the Alpha variant emerged: children aged under 12 years old were crucial in transmission. Stringent social distancing measures in March 2021 helped diminish the noticeable contribution of the [18, 30) age group. By June 2021, as the Delta variant became the predominant strain, adults aged [18, 40) years emerged as main contributors to transmission, with a resurgence in children’s contribution during September-October 2021. This study highlights the effectiveness of our methodology in identifying age-specific transmission patterns.

Date: 2025
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DOI: 10.1038/s41467-025-57087-z

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