Enhanced Surveillance for New Vaccine Preventable Disease-Patient Protection-ACA

这项建议延续并加强了现有的新疫苗监测网络 （NVSN）位于纽约州罗切斯特的研究中心。过度宣传的目标是让全国了解 疫苗可预防疾病（VPD）以及新疫苗和疫苗政策的影响。我们 罗切斯特NVSN站点（NVSN创始成员之一）一直是塑造 NVSN包括对新的或即将到来的疫苗，疫苗 有效性（VE）研究，实验室方法的改进，卫生服务和流行病学 研究和传播结果。我们的建议侧重于急性肠胃炎的活动 (AGE)在幼儿中（轮状病毒，诺如病毒），但在研究各种 急性呼吸道感染（阿里斯）。我们拥有基础设施和全面的专业知识， 从第1天开始开始所有活动。 具体目标是（A）运营一个基于人口的NVSN网站， 病例和健康对照的流行病学、临床和疫苗接种数据，和（B）进行 NVSN活动范围-（B1）加强对年龄组的全年监测， 11岁以下儿童医院和急诊科（艾德）设置和评估人群范围 疾病负担;（B2）每年评估轮状病毒VE;（B3）收集来自 健康对照以更好地定义疾病负担;以及（B4）进行各种可选的 研究，以更好地了解VPD和疫苗的影响。我们提出8种可能的可选方案 研究，所有这些我们都可以根据NVSN的资金和优先事项进行。三个高- 优先选择的研究（我们可以在第二年预算内进行）包括：（B4a）队列研究 评估AGEs和阿里斯的发病率、负担和传播的研究;（B4 b）一项研究， 衡量年龄相关住院和艾德访视的费用;和（B4c）ARI监测， 评估RSV和副流感病毒的负担以及新ARI疫苗（RSV和 副流感病毒），并为我们的AGE重点监测提供ARI控制。 我们的NVSN拥有经验丰富的人员，准确的实验室和监测技术， 杰出的流行病学和卫生服务研究能力。我们完全可以接触到 医院和艾德数据库以补充监测活动。我们的社区是独一无二的， 美国在我们与初级保健实践的杰出合作中，包括获得虚拟 县内所有疫苗接种数据和基于人群的门诊潜力的做法 监视这一建议将为制定健全的政策提供关键信息， 国家目标是预防儿童VPD。

This proposal continues and enhances the existing New Vaccine Surveillance Network (NVSN) site in Rochester, NY. The over-arching goal is to inform the nation about the burden of vaccine-preventable diseases (VPDs) and the impact of new vaccines and vaccine policies. Our Rochester NVSN site (a founding NVSN member), has been a leader in shaping all aspects of the NVSN including population-based surveillance for new or upcoming vaccines, vaccine effectiveness (VE) studies, refinement of laboratory methods, health services and epidemiologic studies, and dissemination of findings. Our proposal focuses activities on acute gastroenteritis (AGE) in young children (rotavirus, norovirus), but has equal strength in studying a variety of acute respiratory infections (ARIs). We have the infrastructure and comprehensive expertise to begin all activities on day 1. The specific aims are to (A) operate a population-based NVSN site to collect epidemiological, clinical, and vaccination data on cases and healthy controls, and (B) conduct a spectrum of NVSN activities-- (B1) conduct enhanced, year-round surveillance for AGE in hospital and emergency department (ED) settings for children <11y and assess population-wide disease burden; (B2) evaluate rotavirus VE annually; (B3) collect AGE surveillance data from healthy controls to better define the disease burden; and (B4) perform a variety of optional studies to better understand VPDs and the impact of vaccines. We propose 8 possible optional studies, all of which we can perform depending on NVSN funding and priorities. Three high- priority optional studies (which we can perform within the Year-2 budget) include: (B4a) a cohort study to evaluate the incidence, burden and transmission of AGEs and ARIs; (B4b) a study to measure the cost of AGE-related hospitalizations and ED visits; and (B4c) ARI surveillance to assess the burden of RSV and parainfluenza and the potential for new ARI vaccines (RSV and parainfluenza) and also to provide ARI controls for our AGE-focused surveillance. Our NVSN has experienced personnel, accurate laboratory and surveillance techniques, and outstanding epidemiologic and health services research capabilities. We have full access to all hospital and ED databases to complement surveillance activities. Our community is unique in the US in our outstanding collaboration with primary care practices including access to virtually all practices in the county for vaccination data and the potential for population-based outpatient surveillance. This proposal will provide critical information to develop sound polices consistent with national goals to preventing VPD in children.