US Hospital Vaccine Effectiveness (VE) Network

美国医院疫苗有效性 (VE) 网络

• 批准号: 9117306
• 负责人: ARNOLD S MONTO
• 金额: $ 3.09万
• 依托单位: UNIVERSITY OF MICHIGAN AT ANN ARBOR
• 依托单位国家: 美国
• 财政年份: 2015
• 资助国家: 美国
• 起止时间: 2015-08-01 至 2020-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9117306
• 关键词: US; Hospital; Vaccine; Effectiveness; VE

 DESCRIPTION (provided by applicant): Prevention of hospitalization has long been viewed as a major health benefit of the use of influenza vaccine. This was, in large part, the rationale for the initial vaccination programs targeting the elderly and those with underlying health conditions. However, in the last decade, questions have been raised about the value of such programs. Modern study designs to assess vaccine effectiveness (VE) have required laboratory confirmation of influenza infection, as well as documentation of vaccine receipt and the use of a test-negative design to control for differences in healthcare-seeking behavior between vaccinated and unvaccinated patients. There is a need for current estimates of VE in preventing influenza-associated hospitalization using these methods. We propose estimation of influenza vaccine effectiveness in preventing influenza hospitalization in two health systems in Michigan, where we have been conducting annual assessments of VE in various populations since 2008. We will conduct surveillance at two hospitals, and will enroll adult in-patients with acute respiratory infection. Vaccination status will be reported and documented, and considered with laboratory-confirmed influenza outcomes to estimate vaccine effectiveness for prevention of hospitalization. Analyses will use a test- negative design; those testing positive for influenza ar cases, those testing negative are controls. Modifiers and confounders of vaccine effectiveness such as age, health status, high-risk health conditions, functional status, frailty, education, tim from illness onset to specimen collection, calendar time, and propensity for vaccination will be assessed. In addition to our proposed influenza surveillance and VE assessment, we propose an estimation of the incidence of hospitalization in adults due to respiratory syncytial virus (RSV and other respiratory viruses. This will allow for the evaluation of bias in influenza VE assessment due to interaction between influenza vaccination, infection, and non-influenza respiratory viruses, and will establish a platform for the future evaluation of RSV vaccines. We will accomplish these additional objectives by expanding our surveillance to months before and after the typical influenza season and evaluating specimens by molecular methods for RSV and other respiratory viruses.

 说明(申请人提供)：长期以来，预防住院一直被视为使用流感疫苗的一项主要健康益处。这在很大程度上是最初针对老年人和有潜在健康状况的人进行疫苗接种计划的理由。 然而，在过去的十年里，人们对这类项目的价值提出了质疑。评估疫苗有效性(VE)的现代研究设计要求对流感感染进行实验室确认，并记录疫苗接收情况，并使用测试阴性设计来控制接种疫苗和未接种疫苗患者之间寻求医疗保健行为的差异。在使用这些方法预防流感相关住院方面，有必要对VE进行当前的估计。我们建议在密歇根州的两个医疗系统中评估流感疫苗在预防流感住院方面的有效性，自2008年以来，我们一直在那里对不同人群的VE进行年度评估。我们将在两家医院进行监测，并将登记患有急性呼吸道感染的成人住院患者。疫苗接种情况将被报告和记录，并与实验室确认的流感结果一起考虑，以评估疫苗预防住院的有效性。分析将采用检测-阴性设计；对流感aR病例检测呈阳性的，检测阴性的为对照。将评估疫苗有效性的影响因素和混杂因素，如年龄、健康状况、高危健康状况、功能状况、虚弱程度、教育程度、从发病到样本采集的时间、日历时间和接种疫苗的倾向。除了我们建议的流感监测和VE评估外，我们还建议估计成人因呼吸道合胞病毒(RSV)和其他呼吸道病毒而住院的发生率。这将允许评估由于流感疫苗接种、感染和非流感呼吸道病毒之间的相互作用而导致的流感VE评估的偏差，并将为未来RSV疫苗的评估建立一个平台。我们将通过将我们的监测扩大到典型流感季节之前和之后的几个月，并通过分子方法评估RSV和其他呼吸道病毒的样本来实现这些额外的目标。