Enhanced Surveillance-Newly Vaccine Preventable Diseases

了解疫苗可预防疾病（VPD）的总体健康负担以及疫苗的影响 提供保健的政策对制定疫苗战略至关重要。我们的罗切斯特新疫苗 监测网络（NVSN）网站（NVSN创始成员），已经证明了巨大的住院负担， VPD使用基于人群的研究与分子病毒诊断。我们建议透过以下措施，加强我们的网络服务 测量和比较医院、急诊科（艾德）和门诊VPD的总负担 护理环境，以及研究当前和新疫苗政策对医疗保健的影响。7个项目在4 提出了主要领域，以确定：A。0<5岁儿童急性 流感（A、B）、RSV（A、B）、副流感病毒（1、2、3）和人偏头痛引起的呼吸道感染， 病毒在该地区仅有的2家儿科医院（300份样本/年），相应的2个ED（300份样本/年），和6个 门诊部位（400个样本/年）; B.）由于采用新疫苗/政策， 流感和肺炎球菌（PCV 7）疫苗的疫苗实践/疫苗覆盖率以及社区 疾病负担（例如PCV 7后的中耳炎）（通过在60个实践中进行4000次图表审查[>85%的 2- 5岁的人群]，并通过分析当地保险数据集[n= 140，000，>70%的人群]， 国家数据集）; C.）流感疫苗预防住院、艾德和门诊就诊有效性（病例- 队列研究-来自所有3种医疗机构的病例，来自社区的对照，以及所有儿童年龄层 6- 23 m和2- 5岁的高危儿童）; D.）轮状病毒病的潜在负担，以准备人口- 基于实验室监测的新疫苗（数据集分析和图表审查）。我们 5年历史的NVSN拥有经验丰富的人员，准确的实验室和监测技术，以及 快速响应新需求。这一建议将为制定健全的政策提供不可或缺的信息 符合预防儿童VPD的国家目标。

Understanding the total health burden of vaccine-preventable diseases (VPD), and the impact of vaccine policies on health care provision is critical to developing vaccine strategies. Our Rochester New Vaccine Surveillance Network (NVSN) site (a founding NVSN member), has demonstrated a large inpatient burden of VPD using population-based studies with molecular viral diagnosis. We propose to enhance our NSVN by measuring and comparing the total burden of VPDs in hospital, Emergency Department (ED), & outpatient care settings, and by studying the healthcare impact of current & new vaccine policies. Seven projects in 4 major areas are proposed, to determine the: A.) population-based burden in children ages 0<5y of acute respiratory infection from influenza (A,B), RSV (A,B), parainfluenza viruses (1,2,3), & human metapneumo- virus in the area's only 2 pediatric hospitals (300 samples/y), corresponding 2 EDs (300 sampies/y), & 6 outpatient sites (400samples/y); B.) changes in healthcare from the introduction of new vaccines/policies on both vaccine practices/vaccine coverage for influenza & pneumococcal (PCV7) vaccines and on community disease burden (e.g. otitis media after PCV7) (by performing 4000 chart reviews in 60 practices [>85% of the population of 2-5y-olds], and by analyzing a local insurance dataset [n=140,000, >70% of population] and national datasets); C.) influenza vaccine effectiveness in preventing hospital, ED, & outpatient visits (case- cohort studies-cases from all 3 healthcare settings, controls from community, and strata of all children ages 6-23m & high risk children ages 2-5y); D.) potential burden of rotavirus disease to prepare for population- based laboratory surveillance for soon anticipated new vaccines (dataset analyses and chart reviews). Our 5y-old NVSN has experienced personnel, accurate laboratory and surveillance techniques, and the ability to respond quickly to new needs. This proposal will provide information integral to developing sound polices consistent with national goals to preventing VPD in children.