US Hospital Vaccine Effectiveness (VE) Network

美国医院疫苗有效性 (VE) 网络

• 批准号: 10179272
• 负责人: ARNOLD S MONTO
• 金额: $ 50万
• 依托单位: UNIVERSITY OF MICHIGAN AT ANN ARBOR
• 依托单位国家: 美国
• 财政年份: 2015
• 资助国家: 美国
• 起止时间: 2015-08-01 至 2020-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10179272
• 关键词: US; Hospital; Vaccine; Effectiveness; VE

 DESCRIPTION (provided by applicant): Prevention of hospitalization has long been viewed as a major health benefit of the use of influenza vaccine. This was, in large part, the rationale for the initial vaccination programs targeting the elderly and those with underlying health conditions. However, in the last decade, questions have been raised about the value of such programs. Modern study designs to assess vaccine effectiveness (VE) have required laboratory confirmation of influenza infection, as well as documentation of vaccine receipt and the use of a test-negative design to control for differences in healthcare-seeking behavior between vaccinated and unvaccinated patients. There is a need for current estimates of VE in preventing influenza-associated hospitalization using these methods. We propose estimation of influenza vaccine effectiveness in preventing influenza hospitalization in two health systems in Michigan, where we have been conducting annual assessments of VE in various populations since 2008. We will conduct surveillance at two hospitals, and will enroll adult in-patients with acute respiratory infection. Vaccination status will be reported and documented, and considered with laboratory-confirmed influenza outcomes to estimate vaccine effectiveness for prevention of hospitalization. Analyses will use a test- negative design; those testing positive for influenza ar cases, those testing negative are controls. Modifiers and confounders of vaccine effectiveness such as age, health status, high-risk health conditions, functional status, frailty, education, tim from illness onset to specimen collection, calendar time, and propensity for vaccination will be assessed. In addition to our proposed influenza surveillance and VE assessment, we propose an estimation of the incidence of hospitalization in adults due to respiratory syncytial virus (RSV and other respiratory viruses. This will allow for the evaluation of bias in influenza VE assessment due to interaction between influenza vaccination, infection, and non-influenza respiratory viruses, and will establish a platform for the future evaluation of RSV vaccines. We will accomplish these additional objectives by expanding our surveillance to months before and after the typical influenza season and evaluating specimens by molecular methods for RSV and other respiratory viruses.

 描述（由申请人提供）：长期以来，预防住院一直被视为使用流感疫苗的主要健康益处。这在很大程度上是最初针对老年人和有潜在健康状况的人的疫苗接种计划的理由。 然而，在过去的十年里，人们对这些计划的价值提出了质疑。评估疫苗有效性（VE）的现代研究设计需要流感感染的实验室确认，以及疫苗接收的文件和使用测试阴性设计来控制接种疫苗和未接种疫苗的患者之间的就医行为差异。目前需要估计VE在预防流感相关住院使用这些方法。我们建议估计流感疫苗在预防流感住院治疗的有效性在密歇根州的两个卫生系统，在那里我们一直在进行VE自2008年以来在不同人群的年度评估。我们将在两家医院进行监测，并将招募患有急性呼吸道感染的成年住院患者。将报告和记录疫苗接种状态，并考虑实验室确认的流感结局，以估计疫苗预防住院的有效性。分析将使用测试阴性设计;那些测试阳性的流感病例，那些测试阴性的是对照。将评估疫苗有效性的修饰因素和混杂因素，如年龄、健康状况、高风险健康状况、功能状态、虚弱、教育程度、从发病到标本采集的时间、日历时间和接种倾向。除了我们建议的流感监测和VE评估外，我们还建议估计成人因呼吸道合胞病毒（RSV和其他呼吸道病毒）住院的发病率。这将允许评价由于流感疫苗接种、感染和非流感呼吸道病毒之间的相互作用而导致的流感VE评估偏倚，并将为RSV疫苗的未来评价建立平台。我们将通过将监测范围扩大到典型流感季节前后的几个月，并通过RSV和其他呼吸道病毒的分子方法评估标本，来实现这些额外的目标。