Component A _ Credible Effectiveness Measures of Seasonal Influenza, COVID-19 and Other Respiratory Virus Vaccines against Ambulatory Care for Acute Illness in Texas (and Component D).

构成部分A--项目摘要/摘要： 流感(流感)病毒在不断进化，需要每个季节都重新配制疫苗。新的SARS- 冠状病毒-2(SC2)变异导致不同地区2019年冠状病毒感染性疾病(COVID)复发 2021-22年冬季美国各地区的气候变化。估计正在进行的真实世界流感和COVID 针对急性疾病的门诊护理的疫苗效力(VE)是评估 全国疫苗接种方案提供的保护和监测保护的持续时间 由各自的疫苗提供，每一种疫苗都是完成疾控中心的使命的高度优先事项 国家健康保护机构。我们的长期研究目标是促进对 呼吸道病毒感染(即季节性和大流行性流感，SC2)的流行病学和预防 和其他呼吸道病毒(ORV)，如呼吸道合胞病毒[RSV])，同时减少 疾病和改善人口健康。我们计划对VE和ACAI进行系统的评估 与实验室确诊的流感、新城疫和疫苗可预防的ORV相关，并分别具有CDC 建议接种的疫苗在贝勒·斯科特和怀特健康中心(BSWCTX)登记符合条件 人口。目标是获得可靠的疫苗接种信息，并提供准确的临时和 在各自符合RV疫苗接种年龄的人群中预防ACAI的VE年度估计数。我们的中央 假设及时和准确地测量VE和疫苗引起的疾病负担是可以预防的 房车是可持续的。基本原理是，通过评估中期和年度VE对可预防疫苗的影响 房车，疾控中心ACIP可以修改接种疫苗和加强剂量的建议，以及使用 适当的抗病毒药物。具体目标是：1)衡量季节性和大流行流感的有效性， 针对ACAI的COVID和疫苗可预防ORV疫苗-实验室确认的轻度至中度 从2022-23年到2026-27年，至少有1,000名儿童和成人感染。2)监控持续的流感 和SC2病毒的进化通过基因组测序在至少1000名登记的儿童和成人中进行 2022-23赛季到2026-27赛季。3)在流感期间执行可能全年的SC2监测 病毒没有传播，以测量实验室确认的轻度至中度SC2的当前COVID VE与ACAI的对应性 2022-23年至2026-27年的儿童和成人感染。为了实现这些目标，我们将 使用测试阴性设计估计门诊环境中的实时VE，估计疾病负担 疫苗可预防的房车在BSWCTX负荷亚组中，并检查影响VE的因素。建议数 研究是创新的，因为我们已经采用了包括经过验证的疫苗接种和准确的实验室诊断的方法 接受系统筛查的参与者中感染一种或两种流感和SC2的轮状病毒感染情况 资格，并在我们的方法中使用定义明确的ACAI案例定义进行登记，使我们能够适当地衡量 美国中西部和中南部地区流感、新城疫和ORV的疾病负担。

COMPONENT A - PROJECT SUMMARY/ABSTRACT: Influenza (Flu) viruses are constantly evolving, requiring vaccines to be reformulated every season. New SARS- CoV-2 (SC2) variants have caused recurrent Coronavirus Infectious Disease – 2019 (COVID) surges in different regions of the United States through the winter of 2021-22. Estimating ongoing real-world Flu and COVID vaccine effectiveness (VE) against ambulatory care for acute illness (ACAI) are essential in evaluating the protection provided by nationwide vaccination programs and for monitoring the duration of protection afforded by respective vaccines each of which are high priorities for fulfilling the CDC’s mission of serving as the nation’s health protection agency. Our long-term research goal is to advance the understanding of the epidemiology and prevention of respiratory virus (RV) infections (i.e., seasonal and pandemic influenza, SC2 and Other Respiratory Viruses (ORVs) such as Respiratory Syncytial Virus [RSV]) while reducing the burden of disease and improving the health of the population. We plan to systematically evaluate the VE against ACAI associated with lab-confirmed influenza, COVID and vaccine-preventable ORVs with respective CDC recommended vaccinations in the Baylor Scott & White Health, Central Texas (BSWCTX) enrollment eligible population. The objective is to obtain reliable vaccination information and to provide accurate interim and annual estimates of VE to prevent ACAI in respective RV vaccine age-eligible population. Our central hypothesis is that timely and accurate measurement of VE and burden of illness due to vaccine preventable RVs is sustainable. The rationale is that by assessing the interim and annual VE against vaccine preventable RVs, the CDC ACIP can modify recommendations for receiving the vaccines and booster doses as well as use of appropriate antiviral agents. The specific aims are to: 1) Measure effectiveness of seasonal and pandemic Flu, COVID and vaccine-preventable ORV vaccines against ACAI for respective lab-confirmed mild to moderate infection in at least 1,000 children and adults from the 2022-23 to 2026-27 seasons. 2) Monitor ongoing Flu and SC2 viral evolution by genomic sequencing among at least 1,000 enrolled children and adults from the 2022-23 to 2026-27 seasons. 3) Perform potentially year-round SC2 surveillance during periods when Flu viruses are not circulating to measure current COVID VE against ACAI for lab-confirmed mild to moderate SC2 infection in children and adults from the 2022-23 to 2026-27 seasons. To accomplish these aims, we will estimate real-time VE in the ambulatory setting using a test-negative design, estimate burden of illness of vaccine preventable RVs in the BSWCTX burden subset, and examine factors affecting VE. The proposed research is innovative as we have adapted methods to include verified vaccinations and accurate lab diagnosis of RV infections with one or both influenza and SC2 in participants who are systematically screened for eligibility and enrolled using a well-defined ACAI case-definition in our approach, enabling us to aptly measure VE and burden of illness of influenza, COVID, and ORVs in the West South Central United States.