Core_Apt Measure of PCR-based Influenza Vaccine Effectiveness in Inpatient Adults

 描述（由申请人提供）：流感病毒不断变化，每年都需要重新配制疫苗。准确评估流感疫苗在预防流感感染方面的有效性对于评估annua全国性疫苗接种计划提供的保护至关重要。我们的长期目标是发现更先进的策略来衡量疫苗的有效性，以潜在地减少流感感染的总体负担。将在Scott和白色纪念医院-坦普尔人口研究区（SWH-TPRA）成人来源人群中系统研究ACIP推荐的普遍免疫策略的流感疫苗有效性。拟议工作的目的是探索在成人住院患者（包括住院率最高的老年人）中测量疫苗对实验室确诊流感（VE-LCI）的有效性的策略 rates.这包括确定、实施和评估创新的、可行的和 在急性住院护理环境中测量18岁或以上人群VE-LCI的可持续策略。中心假设是，在美国，及时有效地测量成人住院患者的VE- LCI是可行的和可持续的。将通过追求三个具体目标来检验这一假设：1）确定创新的、可行的和可持续的策略，以及时有效的方式测量急性住院治疗环境中因急性呼吸道疾病（ARI）入院的≥ 18岁患者的VE-LCI，2）实施上述策略测量成人ARI住院患者的VE-LCI; 3）评价上述策略测量成人ARI住院患者的VE-LCI。为了实现这些目标，将通过实时聚合酶链反应（RT-PCR）测定法，在甲型和/或B型流感病毒检测呈阳性的患有ARI的SWMH成人中确定VE-LCI。在调整混杂因素后，将PCR确认病例接种流感疫苗的几率与年龄匹配的PCR阴性对照进行比较。在2015- 2016年至2019-2020年期间，300名患有ARI的SWMH患者和800名成人将有资格参加BSWH CDC VE-LCI成人住院研究。使用测试阴性研究设计，将测量患有ARI的成年住院患者的VE-LCI。将计算RT-PCR确认病例和试验阴性对照的流感疫苗接种率，调整VE-LCI的混杂因素。该方法是创新的，因为将确定增加流感免疫对疾病负担的公共卫生影响的有效措施。拟议的研究意义重大，因为它将有助于更好地了解VE-LCI的及时有效措施，这反过来又将支持减少流感相关健康负担的目标。

 DESCRIPTION (provided by applicant): Influenza viruses are constantly changing, requiring the reformulation of vaccines every year. Accurately estimating influenza vaccine effectiveness in preventing influenza infection is critical in order to evaluate the protection provided by annua, nationwide vaccination programs. Our long-term goal is to discover more advanced strategies to measure vaccine effectiveness, to potentially reduce the overall burden of influenza infection. The effectiveness of influenza vaccines with the ACIP recommended universal immunization strategy in the Scott and White Memorial Hospital -Temple Population Research Area (SWH-TPRA) adult source population will be systematically investigated. The objective of the proposed work is to explore strategies for measuring vaccine effectiveness against lab-confirmed influenza (VE-LCI) in adult inpatients, including the elderly, who have the highest hospitalization rates. This includes the identification, implementation and evaluation of innovative, feasible, and sustainable strategies for measuring VE-LCI in persons aged 18 years or older in acute inpatient care settings. The central hypothesis is that timely and efficient measurement of VE- LCI in adult inpatients is feasible and sustainable in the U.S. This hypothesis will be tested by pursuing three specific aims: 1) Identify innovative, feasible, and sustainable strategies to measure VE-LCI in a timely and efficient manner for persons ≥ 18 years admitted with an acute respiratory illness (ARI) in acute inpatient care settings, 2) Implement the above strategies to measure VE-LCI for adult inpatients with ARI, and 3) Evaluate the above strategies to measure VE-LCI for adult inpatients with ARI. To achieve these goals, VE-LCI will be determined in adults admitted to SWMH with ARI who test positive for influenza A and/or B by the real-time polymerase chain reaction (RT-PCR) assay. The odds of being vaccinated against influenza for PCR-confirmed cases will be compared to age-matched PCR-negative controls, after adjusting for confounders. During 2015- 2016 through 2019-2020, 300 patients and 800 adults admitted to SWMH with an ARI will be eligible to participate in the BSWH CDC VE-LCI adult inpatient study, respectively. Using a test-negative study design, VE-LCI for adult inpatients with ARI will be measured. Influenza immunization rates will be calculated for the RT-PCR confirmed cases and test negative controls, adjusting VE-LCI for confounders. The approach is innovative because effective measures of the public health impact of increasing influenza immunization on burden of illness will be defined. The proposed research is significant, because it will support improved understanding of timely and efficient measures of VE-LCI, which in turn will support the goal of reducing influenza-associated health burdens.