Enhanced Surveillance-Newly Vaccine Preventable Diseases

了解疫苗可预防疾病(VPD)的总体健康负担以及疫苗的影响 有关卫生保健提供的政策对制定疫苗战略至关重要。我们的罗切斯特新疫苗 监测网络(NVSN)站点(NVSN的创始成员之一)已显示出巨大的住院患者负担 VPD使用基于人群的研究和分子病毒诊断。我们建议通过以下方式增强我们的NSVN 医院、急诊科、门诊VPD总负担的测算与比较 通过研究当前和新的疫苗政策对医疗保健的影响。4个项目中的7个 提出了主要领域，以确定：A.)急性发作期0&5岁儿童的人口负担 由流感(A，B)、呼吸道合胞病毒(A，B)、副流感病毒(1，2，3)和人类偏肺炎引起的呼吸道感染- 病毒在该地区仅有的2家儿科医院(300份/年)，相应的2家急诊室(300份/年)，&6 门诊点(400例/年)；推出新疫苗/政策后医疗保健的变化 流感和肺炎(PCV7)疫苗的疫苗实践/疫苗覆盖率和社区 疾病负担(例如，PCV7后的中耳炎)(通过在60个实践中执行4000个图表审查[&gt；85%的 2-5岁人口]，并通过分析当地保险数据集[n=140,000，&gt；人口的70%]和 国家数据集)；C.)流感疫苗预防住院、急诊和门诊就诊的有效性(病例- 队列研究-来自所有3个医疗保健环境的病例，来自社区的对照，以及所有年龄段的儿童阶层 6-23岁和2-5岁的高危儿童)；轮状病毒病的潜在负担为人口做准备- 以实验室监测为基础，对即将到来的新疫苗进行监测(数据集分析和图表审查)。我们的 成立5年的NVSN拥有经验丰富的人员、准确的实验室和监控技术，以及 快速响应新需求。该提案将为制定健全的政策提供不可或缺的信息。 与预防儿童VPD的国家目标一致。

Understanding the total health burden of vaccine-preventable diseases (VPD), and the impact of vaccine policies on health care provision is critical to developing vaccine strategies. Our Rochester New Vaccine Surveillance Network (NVSN) site (a founding NVSN member), has demonstrated a large inpatient burden of VPD using population-based studies with molecular viral diagnosis. We propose to enhance our NSVN by measuring and comparing the total burden of VPDs in hospital, Emergency Department (ED), & outpatient care settings, and by studying the healthcare impact of current & new vaccine policies. Seven projects in 4 major areas are proposed, to determine the: A.) population-based burden in children ages 0<5y of acute respiratory infection from influenza (A,B), RSV (A,B), parainfluenza viruses (1,2,3), & human metapneumo- virus in the area's only 2 pediatric hospitals (300 samples/y), corresponding 2 EDs (300 sampies/y), & 6 outpatient sites (400samples/y); B.) changes in healthcare from the introduction of new vaccines/policies on both vaccine practices/vaccine coverage for influenza & pneumococcal (PCV7) vaccines and on community disease burden (e.g. otitis media after PCV7) (by performing 4000 chart reviews in 60 practices [>85% of the population of 2-5y-olds], and by analyzing a local insurance dataset [n=140,000, >70% of population] and national datasets); C.) influenza vaccine effectiveness in preventing hospital, ED, & outpatient visits (case- cohort studies-cases from all 3 healthcare settings, controls from community, and strata of all children ages 6-23m & high risk children ages 2-5y); D.) potential burden of rotavirus disease to prepare for population- based laboratory surveillance for soon anticipated new vaccines (dataset analyses and chart reviews). Our 5y-old NVSN has experienced personnel, accurate laboratory and surveillance techniques, and the ability to respond quickly to new needs. This proposal will provide information integral to developing sound polices consistent with national goals to preventing VPD in children.