Core_Prospective population-based estimation of influenza vaccine effectiveness a

基于人群的流感疫苗效力的前瞻性评估 疾病的负担：摘要 摘要 公共卫生政策制定者需要对流感疫苗有效性进行年度评估，因为 正在对美国流感疫苗接种计划进行评估。这些 估计必须来自观察性流行病学研究，这很容易受到 研究设计和分析中的许多偏差来源。此外，政策制定者 需要有关流感发病率和疫苗之间抗原匹配的信息 和传播的流感毒株，以适当地解释疫苗有效性估计。 在团体健康合作社(GHC)的成员中，这是一个管理的医疗组织 华盛顿州西部，我们建议：(1)进行年度检测阴性病例对照 流感疫苗有效性研究。这一设计有效地减少了 疫苗接种人群就医行为差异引起的混淆 和未接种疫苗的受试者。我们可以通过利用 来自GHC电子病历和行政管理的关于我们主题的广泛数据 数据库。我们将通过RT-PCR来验证流感感染情况，并将培养流感 来自RT-PCR阳性样本的病毒，将与疾控中心共享抗原性 人物刻画。(2)估计#年同一人群的流感负担 我们估计疫苗的有效性。为了估计发病率，我们利用 我们的病例对照受试者是从确定的、被列举的人群中抽取的事实 对急性疾病当天护理几乎没有障碍的GHC参与者。超过了 在五年的研究过程中，我们的结果将为公共卫生政策制定者提供 更好地了解流感疫苗的效力如何年复一年地波动 以及这些波动与流感发病率和抗原匹配之间的关系 带着疫苗。

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.