New Vaccine Surveillance Network

总结 急性呼吸道疾病（ARI）和急性胃肠炎（AGE）是导致疾病的主要原因， 美国和全球的孩子们。这些感染造成了发病率、死亡率和死亡率的巨大负担。 除了与育儿假有关的间接费用外，还包括直接保健费用。许多情况 急性呼吸道感染是由病毒引起的，包括流感病毒、呼吸道合胞病毒等。同样，大多数年龄 在美国，它与轮状病毒和其他病毒有关。 很少或没有有效的抗病毒药物，因此接种疫苗是最有希望的 干预流感和轮状病毒的许可疫苗;其他疫苗的候选疫苗 病原体正在发展。积极的前瞻性监测对建立“真实世界”疫苗是必要的 有效性（VE）。此外，基于人群的监测可以发现潜在疫苗的负担- 可预防的疾病，并指导决策者和行业。新疫苗提供的基础设施 监测网络（NVSN）将促进这些目标，以及允许描述的临床 这些疾病的特征，自然史和人口动态。匹兹堡儿童医院 (CHP)提供了一个理想的环境进行拟议的人口为基础的研究，因为卫生防护中心是唯一的 是阿勒格尼县和该地区儿科住院和急诊科（艾德）护理的主要提供者。 我们提出三个具体目标。目标1：评价目前或今后一段时间内 即将到来的疫苗和其他免疫预防策略，并告知儿科疫苗相关 施政纲要而使用测试阴性病例对照方法，我们将计算流感和轮状病毒的年VE 预防ARI和AGE的疫苗。目标2：积极评估AGE和ARI的负担 （包括实验室确认的病毒病因的疾病）。我们将执行 住院或艾德入组的患病受试者中ARI和AGE病毒病因的实验室确认， 和健康儿童访问时登记的健康对照。目的3：建立疾病的自然史， 儿科传染病，传播动态，疫苗对目标人群和弱势群体的影响 人口、社会经济和微生物环境可能与公众 卫生干预措施。我们将采集入组受试者的大量临床和人口统计学数据， 健康对照将对受试者进行其他ARI和AGE相关病毒检测。 该项目的完成将提供有关许可疫苗VE的新数据; 以人口为基础的潜在疫苗可预防疾病的负担;建立自然史， 多种人类病毒的疾病关联。这些结果将指导新疫苗的开发， 抗病毒药物，为公共卫生政策提供信息，并提高美国和全球儿童的健康结果。

Summary Acute respiratory illness (ARI) and acute gastroenteritis (AGE) are leading causes of disease in children in the U.S. and globally. These infections contribute a substantial burden of morbidity, mortality, and direct health care costs, in addition to the indirect costs associated with parental leave from work. Many cases of ARI are caused by viruses, including influenza, respiratory syncytial virus, and others. Similarly, most AGE in the U.S. is associated with viruses, including rotavirus and others. There are few or no effective antivirals for these, and therefore vaccination is the most promising intervention. Licensed vaccines are available for influenza and rotavirus; candidate vaccines for other pathogens are in development. Active, prospective surveillance is necessary to establish “real-world” vaccine effectiveness (VE). Moreover, population-based surveillance can discover the burden of potentially vaccine- preventable diseases and guide policymakers and industry. The infrastructure provided by the New Vaccine Surveillance Network (NVSN) will facilitate these goals, as well as allowing the description of the clinical features, natural history, and population dynamics of these illnesses. The Children’s Hospital of Pittsburgh (CHP) offers an ideal environment to conduct the proposed population-based research, as CHP is the only major provider of pediatric inpatient and Emergency Department (ED) care in Allegheny County and the region. We propose three Specific Aims. Aim 1: To evaluate the effectiveness and impact(s) of current or upcoming vaccines and other immunoprophylaxis strategies, and inform pediatric vaccine-related policies. Using test-negative case-control methods, we will calculate the annual VE of influenza and rotavirus vaccines against medically attended ARI and AGE. Aim 2: To actively assess the burden of AGE and ARI (including illness with laboratory-confirmed viral etiologies) in the pediatric population. We will perform laboratory confirmation of viral etiologies of ARI and AGE among ill subjects enrolled in the inpatient or ED, and healthy controls enrolled at well-child visits. Aim 3: To establish the natural history of disease for pediatric infectious diseases, transmission dynamics, vaccine impacts for targeted and vulnerable populations, and socioeconomic and microbiological environments potentially relevant to public health interventions. We will capture extensive clinical and demographic data on enrolled subjects and healthy controls. Subjects will be tested for additional ARI- and AGE-associated viruses. The completion of this project will provide new data regarding the VE of licensed vaccines; define the population-based burden of potentially vaccine-preventable diseases; and establish the natural history and disease association of multiple human viruses. These results will guide the development of new vaccines and antivirals, inform public health policies, and enhance the health outcomes of children in the U.S. and globally.