RFA-IP-22-004, Platform to Assess Influenza and COVID-19 Vaccine Effectiveness in Underserved Arizona Populations

组分A -摘要： 每年接种流感疫苗是感染和严重疾病的主要预防策略。一个不断 流感病毒通过抗原漂移进化，这就要求每年对疫苗进行重新评估。COVID-19 与流感有重叠症状，并使相关的医疗负担显著复杂化 病毒感染、发病率和死亡率。虽然COVID-19疫苗获得了紧急使用授权， (EUA)美国食品和药物管理局（FDA）正在开发更多的COVID-19疫苗 由于新出现的变异，其中一些已知可以逃避目前授权的疫苗。因此，助推器 建议阻止变异感染的高峰和新一波，这使评估 新冠肺炎疫苗和季节性流感疫苗的有效性。亚利桑那州凤凰城是第五个 最大和发展最快的城市在全国，而且，重要的是，是家庭对一个种族和社会经济 多样的人口。在COVID-19大流行期间，亚利桑那州的人均COVID-19在全球排名第一 例亚利桑那州对COVID-19和流感疫苗的使用混合使用， 优秀的本地比较。在这个项目中，利用亚利桑那州立大学的核心能力，我们 建议在不同的人口统计学和临床人群中研究疫苗有效性（VE）（包括 免疫功能低下的艾滋病毒患者）在ValleyWise社区医院管理的门诊诊所就诊， 凤凰城儿童医院和亚利桑那州立大学学生健康服务。鉴于已确定的感染方面的健康差异， 和疫苗注射，我们建议研究影响健康的社会因素，以找出最易受感染的组别。 我们将收集标本（鼻咽和/或前鼻拭子）和相关人口统计学和临床 儿童和成人急性呼吸道感染的实验室确诊流感和COVID-19病例数据 感染，在门诊诊所寻求治疗，以计算流感和COVID的疫苗有效性- 19种疫苗我们还将对病毒基因组进行测序，利用我们深厚的专业知识识别亚型/变体， 在下一代测序和病毒基因组生物信息学方面拥有无与伦比的资源。我们将使用这个 基因组测序数据，以进一步研究VE分析和了解病毒进化。重要的是 检查疫苗接种和疫苗有效性方面的健康差距，我们将实施纵向调查， 地理信息系统制图，以衡量和模拟健康的社会决定因素。总体而言，我们 多学科计划提供了一个全面的方法来研究VE和了解社会 决定了健康差距的形成。我们相信，这些发现将对我们的政策产生重要而持久的影响。 对疫苗接种和VE检查的影响。

Component A – Abstract: Annual influenza vaccination is the primary prevention strategy for infection and severe disease. A constantly evolving influenza virus through antigenic drift dictates that vaccines are re-evaluated every year. COVID-19 has overlapping symptoms with influenza and has significantly complicated the healthcare burden associated with viral infections, morbidity, and mortality. While COVID-19 vaccines received Emergency Use Authorization (EUA) from the Food and Drug Administration (FDA), additional COVID-19 vaccines are under development due to emerging variants, some of which are known to evade currently authorized vaccines. As such, boosters are recommended to thwart spikes and new waves of variant infections which complicates assessment of the effectiveness of both COVID-19 and seasonal influenza vaccines simultaneously. Phoenix, Arizona is the fifth largest and fastest growing city in the nation, and, importantly, is home to an ethnically and socioeconomically diverse population. Twice during the COVID-19 pandemic, Arizona was #1 worldwide in per capita COVID-19 cases. Arizona has seen a mixed adoption of vaccine use for both COVID-19 and influenza, allowing for excellent local comparisons. In this project, leveraging Arizona State University’s (ASU) core capabilities, we propose to study vaccine effectiveness (VE) in a diverse demographic and clinical population (including immunocompromised HIV patients) seen at outpatient clinics managed by ValleyWise Community Hospital, Phoenix Children’s Hospital and ASU Student Health Services. Given identified health disparities in infection and vaccination, we propose to examine social determinants of health to identify the most vulnerable groups. We will collect specimens (nasopharyngeal and/or anterior nasal swabs) and relevant demographic and clinical data from laboratory-confirmed cases of influenza and COVID-19 in children and adults with acute respiratory infection, seeking care in ambulatory clinics, to calculate vaccine effectiveness for both influenza and COVID- 19 vaccines. We will also sequence viral genomes to identify subtype/variants using our deep expertise and incomparable resources in next-generation sequencing and viral genomic bioinformatics. We will use this genomic sequencing data to further investigate VE analyses and understand virus evolution. Importantly, to examine health disparities in vaccination and vaccine effectiveness, we will implement longitudinal surveys and geographical information systems mapping to measure and model social determinants of health. Overall, our multidisciplinary program provides a comprehensive approach to study VE and to understand social determinates that drives health disparities. We believe the findings will have important, long lasting policy implications towards vaccination and examination of VE.