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

A部分--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。一成不变的 通过抗原漂移进化的流感病毒决定了疫苗每年都要重新评估。新冠肺炎 与流感症状重叠，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。新冠肺炎疫苗获得紧急使用授权 (EUA)美国食品和药物管理局(FDA)正在开发其他新冠肺炎疫苗 由于出现了新的变种，其中一些已知可以逃避目前授权的疫苗。因此，推动者 建议用于阻止高峰和新一波变异感染，这将使对 新冠肺炎和季节性流感疫苗同时生效。亚利桑那州凤凰城是第五个 全国最大、发展最快的城市，重要的是，它是一个种族和社会经济 多样化的人口。在新冠肺炎大流行期间，亚利桑那州的人均新冠肺炎两次位居世界第一 案子。亚利桑那州新冠肺炎和流感疫苗混合使用，允许 出色的本地比较。在这个项目中，利用亚利桑那州立大学(ASU)的核心能力，我们 建议在不同的人口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 在疫苗接种方面，我们建议审查健康的社会决定因素，以确定最脆弱的群体。 我们将收集样本(鼻咽和/或前鼻拭子)以及相关的人口统计学和临床数据。 实验室确诊的流感和新冠肺炎儿童和成人急性呼吸道感染病例数据 感染，在门诊寻求护理，以计算流感和COVID的疫苗效力- 19种疫苗。我们还将利用我们深厚的专业知识对病毒基因组进行测序，以确定亚型/变异 在下一代测序和病毒基因组生物信息学方面的无与伦比的资源。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， 检查接种疫苗和疫苗有效性方面的健康差距，我们将实施纵向调查和 测绘地理信息系统，以衡量和模拟健康的社会决定因素。总的来说，我们的 多学科项目提供了学习VE和理解社会的综合方法 决定了造成健康差距的因素。我们相信，这些发现将具有重要的、长期的政策 对VE疫苗接种和检查的影响。

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.