Effect of Maternal Influenza Vaccination during Pregnancy on Risk of Infant Influenza

项目概要：为孕妇接种疫苗以保护婴儿是一项日益增长的公共卫生 因为这种方法使用一种疫苗来保护两个人。但不清楚 怀孕期间接种流感疫苗是否能保护婴儿免受严重流感的侵害， 改变了随后给予婴儿的流感疫苗的有效性。是 关键是我们要了解这种做法的好处和可能的意外后果。 尽管几十年来一直建议孕妇接种流感疫苗， 这一人群的疫苗接种率仍然很低，原因尚不完全清楚。的 这项建议的具体目标是：1）确定母亲是否接种流感疫苗， 在怀孕期间保护0 - 12个月的婴儿免受流感（定义为a）严重 流感（即，住院），B）实验室确认的流感或c）任何流感或 流感样疾病），以及效果是否因接种疫苗的三个月而异; 2）评估 婴儿在6 - 12个月大时首次接种流感疫苗的有效性是否被修改 在怀孕期间接种流感疫苗;以及3）检查是否有流感未接种疫苗 在怀孕期间集群地理，并确定这些集群是否与 怀孕期间的流感和流感样疾病。目标将利用先进的 教学培训，受益于经验丰富的导师团队，并应用最先进的 因果推理和地理聚类分析技术。他们会利用 Kaiser Permanente北方加州人口数据的深度和广度， 由凯撒永久研究部提供的综合培训环境。的 这项研究的直接影响是，它可以导致改变目前的政策， 孕妇接种流感疫苗。申请的职业发展部分 旨在为Zerbo博士提供疫苗学方面的专业知识，先进的统计方法， 额外的研究技能，目标是让他成为一名独立的调查员， 疫苗的有效性主要针对孕妇和婴儿。随着越来越多的疫苗 为孕妇开发，确定其有效性及其相互作用和影响 对婴儿免疫系统的影响将越来越重要。

Project Summary: Vaccinating pregnant women to protect infants is a growing public health trend because this approach utilizes one vaccine to protect two people. However, it is unknown whether influenza vaccination during pregnancy protects infants against severe influenza or modifies the effectiveness of influenza vaccines subsequently administered to infants. It is critical that we understand the benefits and possible unintended consequences of this practice. Although influenza vaccines have been recommended for pregnant women for decades, vaccine uptake in this population remains low for reasons that are incompletely understood. The specific aims of this proposal are: 1) To determine whether maternal influenza vaccination during pregnancy protects infants 0 – 12 months against influenza (defined as a) severe influenza (i.e., hospitalization), b) laboratory-confirmed influenza or c) any influenza or influenza-like illness), and whether the effect varies by trimester of vaccination; 2) Evaluate whether the effectiveness of Infants' first influenza vaccination at age 6 – 12 months is modified by influenza vaccination during pregnancy; and 3) Examine whether influenza non-vaccination during pregnancy clusters geographically, and determine if those clusters are associated with influenza and influenza-like illnesses during pregnancy. The aims will leverage advanced didactic training, benefit from an experienced mentorship team, and apply use of cutting-edge causal inference and geographical cluster analysis techniques. They will harness the incredible depth and breadth of the Kaiser Permanente Northern California's population data and the comprehensive training environment afforded by Kaiser Permanente Division of Research. The direct impact of this research is that it can lead to changes to current policies regarding influenza vaccination in pregnant women. The career development component of the application is designed to provide Dr. Zerbo with expertise in vaccinology, advance statistical methods and additional research skills with the goal to prepare him to become an independent investigator in vaccine effectiveness focused on pregnant women and infants. As more vaccines are developed for pregnant women, determining their effectiveness and their interaction and effect on infant immune system will be increasingly important.