Mandatory_Estimates of Vaccine Effectiveness Against Medically-Attended, PCR-Confirmed Influenza in West South Central U.S.

流感病毒在不断进化，导致每年都会选择疫苗毒株进行重新配制。 赛季到了。每年对流感疫苗在预防流感相关发病率方面的有效性估计为 在评估年度全国疫苗接种计划所提供的保护方面至关重要。我们的长期目标 是促进对呼吸道病毒感染的流行病学的了解，同时测量公众 免疫接种对减轻总体疾病负担和改善老年人健康的健康影响 人口。我们计划用疾控中心ACIP推荐的年度标准对流感VE进行系统评估 德克萨斯州中部贝勒·斯科特和怀特健康(BSWCTX)患者的普遍免疫策略 人口。目标是为登记的人口获得可靠的疫苗接种信息，并提供 对每年VE的准确估计，以预防与流感相关的医疗参与的急性呼吸道疾病 (Maari)在符合接种年龄的人群中。我们的中心假设是，及时和高效 衡量因季节性/大流行流感、呼吸道合胞病毒和其他疾病引起的年度VE和疾病负担 呼吸道病毒是可持续的。理由是，通过评估赛季中期的VE，ACIP可以推荐 根据需要，对高危人群进行抗病毒化学预防和治疗。为完成总目标， 将实现以下具体目标：1)根据实验室确认的流感评估流感VE 在至少1,000名儿童和成人中，包括来自三个年龄组(6个年龄段)各至少333人 月-17岁，18-49岁，≥50岁)，在5个赛季中的每一个赛季，马利都在门诊环境中 2016-17年间，6个月至8岁的幼儿中至少有100人， 年龄为≥65岁的成年人。2)评估季节性流感造成的疾病负担(从 2016-17年)，呼吸道合胞病毒和其他呼吸道病毒(在3-5个季节)在儿童(6个月至17岁)中传播， 成年人(18岁-)和老年人(65岁≥)。3)制定流感大流行防备措施 业务计划和试点研究方法(在第3-5季)，以描述该小说的流行病学 流感病毒感染，从世界任何地方每当下一次流感大流行迫在眉睫时开始， 估计大流行性流感的发病率，估计季节性和大流行性流感疫苗的VE 用于预防与大流行性流感相关的MAARI，并评估抗病毒药物的使用和效果 治疗大流行性流感的药物。为了实现这些目标，我们将为以下目标估计实时VE 在门诊环境中使用试验阴性设计的登记人口，估计疾病负担 BSWCTX来源人群中的季节性/大流行性流感、RSV和其他呼吸道病毒；以及 检查与VE相关的因素。拟议的研究具有创新性，因为它将产生新的知识 在用于在不同医疗保健环境中适当地测量流感病毒VE和测量 美国西南中南部地区流感、呼吸道合胞病毒和其他呼吸道病毒的疾病

Influenza viruses are constantly evolving, resulting in vaccine strains being selected for reformulation every season. Annual estimates of influenza vaccine effectiveness (VE) in preventing influenza-related morbidity are essential in evaluating the protection provided by annual, nationwide vaccination programs. Our long-term goal is to advance the understanding of the epidemiology of viral respiratory infections while measuring the public health impact of immunization on reducing the overall burden of illness and on improving the health of the population. We plan to systematically evaluate the influenza VE with the CDC ACIP recommended annual universal immunization strategy in the Baylor Scott & White Health, Central Texas (BSWCTX) patient population. The objective is to obtain reliable vaccination information for the enrolled population and provide accurate estimates of annual VE to prevent influenza-associated medically-attended acute respiratory illness (MAARI) in the vaccine age-eligible population. Our central hypothesis is that timely and efficient measurement of annual VE and burden of illness due to seasonal/pandemic influenza, RSV and other respiratory viruses is sustainable. The rationale is that by assessing the mid-season VE, ACIP can recommend antiviral chemoprophylaxis and treatment for high risk groups, as needed. To accomplish the overall objective, the following specific aims will be pursued: 1) Assess influenza VE against laboratory-confirmed influenza among at least 1,000 children and adults, including at least 333 persons from each of three age groups (6 months – 17 years, 18-49 years and ≥50 years) with MAARI in ambulatory settings during each of 5 seasons from 2016-17, with at least 100 among young children aged 6 months – 8 years and with at least 100 among adults aged ≥65 years. 2) Evaluate disease burden due to seasonal influenza (during each of 5 seasons from 2016-17), RSV and other respiratory viruses (during seasons 3-5) among children (ages 6 months – 17 years), adults (ages 18-64 years) and older adults (ages ≥65 years). 3) Develop influenza pandemic preparedness operational plan and pilot research methods (during seasons 3-5) to describe the epidemiology of the novel influenza virus infection, beginning whenever the next influenza pandemic is imminent anywhere in the world, estimate MAARI incidence of pandemic influenza, estimate VE of seasonal and pandemic influenza vaccines for prevention of pandemic influenza-associated MAARI, and evaluate the use and effectiveness of antiviral agents for treatment of pandemic influenza. To accomplish these goals, we will estimate real-time VE for the enrolled population in the ambulatory setting using a test-negative design, estimate burden of illness of seasonal/pandemic influenza, RSV and other respiratory viruses in the BSWCTX source population, and examine factors associated with VE. The proposed research is innovative in that it will generate new knowledge in the methods used to aptly measure influenza VE in different healthcare settings and measure burden of illness of influenza, RSV and other respiratory viruses in the West South Central region of the U.S.