Enhanced Surveillance for New Vaccine Preventable Disease

描述（由申请人提供）：本提案继续并加强了纽约州罗切斯特市现有的新疫苗监测网络（NVSN）站点。总体目标是向全国通报疫苗可预防疾病的负担以及新疫苗和疫苗政策的影响。我们的罗彻斯特NVSN网站（NVSN创始成员之一）在塑造NVSN的各个方面都处于领先地位，包括对新疫苗或即将推出的疫苗进行基于人群的监测、疫苗有效性（VE）研究、改进实验室方法、卫生服务和流行病学研究以及研究结果的传播。我们的建议侧重于幼儿急性胃肠炎（AGE）（轮状病毒，NoV）的活动，但在研究各种急性呼吸道感染（ARIs）方面具有同等的优势。我们有基础设施和全面的专业知识，可以在第一天开始所有的活动。具体目标是：(A)运营一个以人群为基础的NVSN站点，收集病例和健康对照的流行病学、临床和疫苗接种数据；(B)开展一系列NVSN活动——（B1）在医院和急诊科（ED）环境中对<11岁儿童的AGE进行加强的全年监测，并评估全人群的疾病负担；（B2）每年评估轮状病毒VE；（B3）收集健康对照者的年龄监测数据，以更好地确定疾病负担；（B4）开展各种可选研究，以更好地了解vpd和疫苗的影响。我们提出了8项可能的可选研究，我们可以根据NVSN的资金和优先级执行所有这些研究。三个高度优先的可选研究（我们可以在第2年预算内进行）包括：（B4a）一项队列研究，以评估age和ARIs的发病率、负担和传播；（B4b）测量年龄相关住院和急诊科就诊成本的研究；（B4c）急性呼吸道感染监测，以评估呼吸道合流病毒和副流感病毒的负担以及开发新型急性呼吸道感染疫苗（呼吸道合流病毒和副流感病毒）的潜力，并为我们以年龄为重点的监测提供急性呼吸道感染控制。我们的NVSN拥有经验丰富的人员，准确的实验室和监测技术，以及出色的流行病学和卫生服务研究能力。我们可以访问所有医院和急诊科的数据库，以补充监测活动。我们的社区在美国是独一无二的，因为我们与初级保健实践进行了出色的合作，包括获得县几乎所有实践的疫苗接种数据和基于人群的门诊监测的潜力。这项建议将提供关键信息，以制定符合国家预防儿童VPD目标的健全政策。

DESCRIPTION (provided by applicant): 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, NoV), 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. PUBLIC HEALTH RELEVANCE: This project enhances the existing New Vaccine Surveillance Network site in Rochester, NY. The major activities, focusing on acute gastroenteritis in children, are to evaluate the burden of gastroenteritis in hospital and emergency department settings, to measure the effectiveness of rotavirus vaccine, and to assess the disease burden of NoV and other viruses on children. The over-arching goal is to inform the nation about the burden of vaccine-preventable diseases and the impact of new vaccines and vaccine policies upon the healthcare and health outcomes of children.