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The New York City public school system is the largest in the US, with more than 1600 schools and more than 1 million enrolled students. For the 2021-2022 school year, COVID-19 safety measures included mandatory vaccination for all adults; daily health screening; universal face coverings; improved indoor air quality using windows, portable air purifiers, and/or central air filtration; testing of unvaccinated persons; and quarantine for unvaccinated contacts.1 There was substantial concern that the Delta variant, which caused a surge in July to August 2021, would disrupt the school year. To assess the effectiveness of COVID-19 prevention measures against the Delta variant, we measured the secondary attack rate for COVID-19 cases diagnosed in students, teachers, and staff from October 10 to December 5, 2021, and analyzed the likely direction of transmission for secondary cases, stratified by vaccination status.
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CME Disclosure Statement: Unless noted, all individuals in control of content reported no relevant financial relationships. If applicable, all relevant financial relationships have been mitigated.
Accepted for Publication: March 31, 2022.
Published: May 23, 2022. doi:10.1001/jamanetworkopen.2022.13276
Open Access: This is an open access article distributed under the terms of the CC-BY License. © 2022 Varma JK et al. JAMA Network Open.
Corresponding Author: Jay K. Varma, MD, Weill Cornell Medicine, 402 E 67th St, Room LA-215, New York, NY 10065 (firstname.lastname@example.org).
Author Contributions: Mss Feldkamp and Alexander had full access to all of the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis.
Concept and design: Varma, Alexander, Norman, Long.
Acquisition, analysis, or interpretation of data: All authors.
Drafting of the manuscript: Varma, Feldkamp, Long.
Critical revision of the manuscript for important intellectual content: All authors.
Statistical analysis: Feldkamp, Alexander, Davis, Long.
Administrative, technical, or material support: Varma, Norman, Agerton, Long.
Supervision: Varma, Norman, Long.
Conflict of Interest Disclosures: Dr Varma reported receiving personal fees from Fund for Public Health of New York, paid by New York City Health Department, to consult on COVID-19 during the conduct of the study; and personal fees from Opentrons LLC outside the submitted work. No other disclosures were reported.
Additional Contributions: Ricardo Anderson, MS, and Taehan Lee, BA, New York Health and Hospitals, assisted with data management. They were not compensated outside pay for their routine work duties.
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