Core_Prospective population-based estimation of influenza vaccine effectiveness a

基于人群的流感疫苗有效性前瞻性评估 疾病负担：摘要 摘要 公共卫生决策者需要每年评估流感疫苗的有效性， 对美国流感疫苗接种计划的持续评估。这些 估计数必须来自观察性流行病学研究，这些研究容易受到 研究设计和分析中的众多偏倚来源。此外，政策制定者 需要关于流感发病率和疫苗之间抗原匹配的信息 和流行的流感病毒株，以正确解释疫苗的有效性估计。 在团体健康合作社（GHC）的成员中， 西部华盛顿州，我们建议：（1）每年进行测试阴性病例对照 流感疫苗有效性的研究。这种设计有效地减少了 接种疫苗者之间就医行为差异引起的混淆 和未接种疫苗的受试者。我们可以进一步减少混杂， 来自GHC电子病历和行政管理的关于我们受试者的广泛数据 数据库。我们将通过RT-PCR验证流感感染， 来自RT-PCR阳性标本的病毒，与CDC共享抗原性 特征化(2)估计同一人群中流感的负担， 我们估计疫苗的有效性。为了估计发病率，我们利用 事实上，我们的病例对照受试者来自一个定义的，枚举的人群， 的GHC注册者几乎没有障碍，可以在同一天护理急性疾病。来 在五年的研究期间，我们的结果将为公共卫生政策制定者提供一个 更好地了解流感疫苗的有效性如何在不同年份波动， 年，以及这些波动与流感发病率和抗原匹配的关系 注射疫苗

Prospective population-based estimation of influenza vaccine effectiveness and burden of disease: Abstract ABSTRACT Public health policy makers need annual estimates of influenza vaccine effectiveness as an ongoing evaluation of the United States influenza vaccination program. These estimates must come from observational epidemiologic studies, which are susceptible to numerous sources of bias in study design and analysis. Furthermore, policy makers need information on influenza incidence and on antigenic match between the vaccine and circulating influenza strains to properly interpret vaccine effectiveness estimates. Among members of Group Health Cooperative (GHC), a managed care organization in western Washington State, we propose: (1) To conduct annual test-negative case-control studies of influenza vaccine effectiveness. This design is effective at reducing confounding caused by differences in healthcare-seeking behavior between vaccinated and unvaccinated subjects. We can further reduce confounding by making use of extensive data on our subjects from GHC electronic medical records and administrative databases. We will verify influenza infection by RT-PCR, and will culture influenza viruses from RT-PCR-positive specimens, to be shared with CDC for antigenic characterization. (2) To estimate the burden of influenza in the same population in which we estimate vaccine effectiveness. For estimating incidence, we take advantage of the fact that our case-control subjects are drawn from a defined, enumerated population of GHC enrollees who have few barriers to same-day care for acute illnesses. Over the course of the five year study period our results will give public health policy makers a greater understanding of how influenza vaccine effectiveness fluctuates from year to year, and how those fluctuations are related to influenza incidence and antigenic match with the vaccine.