Children and adolescents, aged 4 to 14 years, could self-collect nasal swab in an adequate manner, which were almost same as the nasal swabs collected by healthcare workers, according to a study published in the Journal of the American Medical Association.^1,2

A total of 197 children, aged 4 to 14 years (median 9 years), with symptoms of Covid-19 were enrolled in this study to investigate if they could satisfactorily collect nasal swabs by themselves for testing after following instructions that were tailored according to their age by comparing them with a second sample collected by healthcare workers. A 90-second video and handouts with written instructions and accompanying pictures were given to children for swab collection. The participants were recruited from the Children’s Healthcare of Atlanta system from July to August 2021.

A 97.8% concurrence for positive results was observed between self-collected nasal swabs and those collected by the healthcare worker. For negative results, it was 98.1%. About 44% of children tested positive for SARS-CoV-2 on RT PCR and ~54% were negative using both self-collected and health care worker–collected specimens. The Ct values were also comparable between the two groups; 26.7 for self-collected samples vs 26.3 for samples collected by the healthcare worker. Nearly 22% of children younger than 8 years required additional help compared to 6.1% children older than 8 years. However, the results in these two age groups were equivalent.

The FDA has authorized many self-test Covid-19 tests for self-collected nasal swabs not only for adults but also children aged 14 years and older and parental collection for children aged 2 years and older.

This study shows that with appropriate instructions, children younger than 14 years up to 4 years of age, could also successfully self-collect nasal swabs for SARS-CoV-2 testing as the results were closely in consonance with results of samples collected by trained health care workers. In settings with scarce resources, self-swabbing by school age children may be implemented as it can facilitate and also expedite testing for school age children.

References

1. Jesse J Waggoner, et al. Concordance of SARS-CoV-2 results in self-collected nasal swabs vs swabs collected by health care workers in children and adolescents. JAMA. 2022 Aug 26. doi: 10.1001/jama.2022.14877.
2. National Institutes of Health Press release, August 26, 2022.