Alternative Strategies for Adult Pneumococcal Vaccination

成人肺炎球菌疫苗接种的替代策略

• 批准号: 7523081
• 负责人: KENNETH J SMITH
• 金额: $ 22.73万
• 依托单位: UNIVERSITY OF PITTSBURGH AT PITTSBURGH
• 依托单位国家: 美国
• 财政年份: 2008
• 资助国家: 美国
• 起止时间: 2008-09-15 至 2012-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7523081
• 关键词: Address; Adult; Age; Area; Bacterial Infections; Centers for Disease Control and Prevention (U.S.); Child; Childhood; Clinical Trials; Communicable Diseases; Comorbidity; Computer Simulation; Condition; Conjugate Vaccines; Data; Data Collection; Decision Making; Disease; Effectiveness; Elderly; Ensure; Epidemiology; Future; Goals; Herd Immunity; Immunity; Incidence; Infection; Invasive; Investigation; Lead; Modeling; Morbidity - disease rate; Persons; Pneumococcal Infections; Pneumococcal conjugate vaccine; Pneumococcal vaccine; Policies; Polysaccharides; Polyvalent pneumococcal vaccine; Prevalence; Prevention strategy; Public Health; Range; Rate; Recommendation; Research; Resolution; Resource Allocation; Resources; Safety; Schedule; Serotyping; Streptococcus pneumoniae; Structure; Techniques; Testing; Time; Today; Uncertainty; Vaccination; Vaccines; aged; base; cohort; cost effectiveness; day; disease transmission; disorder prevention; disorder risk; infectious disease model; mathematical model; mortality; novel; prevent; response; simulation; size; transmission process; trend; uptake; vaccination strategy; vaccine effectiveness

DESCRIPTION (provided by applicant): Streptococcus pneumoniae is a major cause of morbidity and mortality; pneumococcal polysaccharide vaccination (PPV) to prevent invasive pneumococcal disease (IPD) has been recommended for all persons aged >65 and for younger persons with comorbidities. However, IPD prevention is less than optimal, due in part to infections in persons without vaccine indication and waning immunity after PPV. Recent changes in pneumococcal serotype epidemiology resulting from the childhood pneumococcal conjugate vaccine (PCV) further complicate vaccine policy decision making. IPD due to PCV-related pneumococcal serotypes has significantly decreased in adults but much less so in those with comorbid conditions, prompting investigation of other vaccination strategies, including PPV every 10-15 years and the addition of adult PCV. Clinical trials testing multiple vaccination regiments would be difficult, expensive, and perhaps unhelpful, given rapid epidemiologic changes. Modeling techniques, synthesizing existing data and projecting likely future scenarios could be useful in determining vaccination strategy feasibility and pointing out areas of uncertainty where further data collection would be most valuable. To this end, we propose to: 1) forecast changes in adult pneumococcal serotype epidemiology resulting from childhood PCV using an infectious disease transmission dynamic model and 2) calculate the effectiveness and cost-effectiveness of alternative adult pneumococcal vaccination strategies incorporating forecasted PCV epidemiologic effects. Areas of data uncertainty will be fully incorporated in the model using recently developed analytic frameworks, which will allow probabilistic representation of results and, through value of information analysis techniques, provide evidence-based guidance for optimal future research resource allocation. PUBLIC HEALTH RELEVANCE Disease due to Streptococcus pneumoniae continues to be a significant public health issue, and improvements in preventive strategies are needed. This research will produce a mathematical model to assist pneumococcal vaccine policymaking, particularly in prioritizing and allocating resources to future research efforts.

描述（由申请人提供）：肺炎链球菌是发病和死亡的主要原因；建议所有 65 岁以上的人和有合并症的年轻人接种肺炎球菌多糖疫苗 (PPV) 以预防侵袭性肺炎球菌疾病 (IPD)。然而，IPD 的预防效果并不理想，部分原因是无疫苗指征的人群感染以及 PPV 后免疫力下降。儿童肺炎球菌结合疫苗（PCV）导致肺炎球菌血清型流行病学的最新变化进一步使疫苗政策决策变得更加复杂。 PCV 相关肺炎球菌血清型引起的 IPD 在成人中显着下降，但在患有合并症的患者中则少得多，这促使人们研究其他疫苗接种策略，包括每 10-15 年接种一次 PPV 以及添加成人 PCV。鉴于流行病学的迅速变化，测试多种疫苗接种方案的临床试验将是困难的、昂贵的，而且可能没有帮助。建模技术、综合现有数据和预测未来可能的情况可能有助于确定疫苗接种策略的可行性，并指出进一步收集数据最有价值的不确定领域。为此，我们建议：1) 使用传染病传播动态模型预测儿童 PCV 引起的成人肺炎球菌血清型流行病学变化；2) 计算纳入预测 PCV 流行病学效应的替代成人肺炎球菌疫苗接种策略的有效性和成本效益。数据不确定性领域将使用最近开发的分析框架完全纳入模型中，这将允许结果的概率表示，并通过信息分析技术的价值，为未来优化研究资源分配提供基于证据的指导。公共卫生相关性 肺炎链球菌引起的疾病仍然是一个重大的公共卫生问题，需要改进预防策略。这项研究将产生一个数学模型，以协助肺炎球菌疫苗的政策制定，特别是在为未来的研究工作确定优先顺序和分配资源方面。