Control of Epidemic Influenza

控制流行性感冒

• 批准号: 7012320
• 负责人: Pedro A Piedra
• 金额: $ 117.08万
• 依托单位: BAYLOR COLLEGE OF MEDICINE
• 依托单位国家: 美国
• 财政年份: 1997
• 资助国家: 美国
• 起止时间: 1997-09-15 至 2008-01-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7012320
• 关键词: active immunization; adolescence (12-20); age difference; child (0-11); clinical research; communicable disease control; disease outbreaks; human subject; human therapy evaluation; immunity; influenza; influenza vaccines; information dissemination; public health; student health services

DESCRIPTION: (provided by applicant) Yearly influenza epidemics continue unabated and are responsible for significant disease and financial burden. Influenza is a vaccine-preventable disease. It is also listed by NIAID as a high priority Category C emerging/reemerging infectious disease threat for which additional methods of prevention and treatment are sought. The primary goal of the original grant "Control of Epidemic Influenza" funded from 1997-2003 was to assess the potential of immunization of pre-school and school-aged children with influenza vaccine to control epidemic influenza through herd immunity. To address this aim, we performed an open-labeled, nonrandomized, community-based trial in children 18 months through 18 years of age with the investigational cold-adapted influenza vaccine, trivalent (CAIV-T). In the four vaccination years of the study we administered 18,780 doses of CAIV-T to 11,096 children. This represented annual vaccination coverage of 20-25 percent of age-eligible children. Some of our findings were 1) an indirect effectiveness (herd immunity) of 8-18 percent against influenza-associated illnesses in adults; 2) a single dose of CAIV-T in children was associated with significant protection that lasted through at least two influenza seasons, and 3) CAIV-T was safe and not associated with an increase in health care utilization. The goal of this renewal application is the control of epidemic influenza through immunization of school-aged children with CAIV-T, which may serve as an option for pandemic preparedness and biodefense. The specific aims are 1) to control the spread of influenza to susceptible adults greater than or equal to 35 years of age by vaccination of school-aged children. The adult age group is likely to benefit most from herd immunity during influenza epidemics. 2) To control the spread of influenza to susceptible children and young adults. Protection for this age group (<35 years of age) requires higher vaccination coverage before herd immunity is observed in the unvaccinated individuals. 3) To develop a school-based vaccination program for rapid and timely delivery of CAIV-T vaccine. A school-based influenza vaccination program could serve as a model for control of both influenza and other high priority pathogens. 4) To capture safety information of CAIV-T post-licensure. Our vaccination goal is 50 percent coverage each year (approximately 8,000 school-aged children). Emphasis will be placed on developing a school-based vaccination program. The trial will be a continuation of the open-labeled, non-randomized, community-based trial in central Texas which includes active viral surveillance in Scott & White clinics in the intervention and comparison communities, disease-based surveillance in Scott & White clinics in the intervention and comparison communities, and an integrated approach with local health department, medical establishment and news media to enhance the public awareness of influenza through dissemination of information to the medical establishment, general public, and news media outlets.

描述：（由申请人提供）年度流感流行病继续没有减弱，并负责重大疾病和经济负担。流感是一种可预防疫苗的疾病。 NIAID还将其列为高优先级类别C c新兴/重新出现传染病威胁，为此寻求其他预防和治疗方法。 1997 - 2003年资助的原始赠款“控制流行性流感”的主要目标是评估流感疫苗的学龄前儿童和学龄儿童免疫的潜力，以通过群疫苗免疫来控制流行性流感。为了解决这一目标，我们在18个月至18岁的儿童中进行了开放标记的，非随机的，基于社区的试验，研究冷的流感疫苗，三价（CAIV-T）。在研究的四个疫苗接种年中，我们服用了18,780剂CAIV-T至11,096名儿童。这代表了20-25％符合年龄符合年龄的儿童的年度疫苗接种覆盖率。我们的一些发现是1）对成年人中与流感相关疾病的间接有效性（HERD免疫）为8-18％； 2）一剂在儿童中的CAIV-T与至少两个流感季节持续的显着保护有关，而3）CAIV-T是安全的，与医疗保健利用率的增加无关。这种更新应用的目的是通过对患有CAIV-T的学龄儿童进行免疫来控制流行性流感，这可以作为大流行准备和生物陷入困境的选择。具体目的是1）控制流感的易感成年人的传播，这是通过疫苗接种学龄儿童的年龄大于或等于35岁。在流感流行期间，成年年龄段可能会从牛群免疫中受益。 2）控制流感对易感儿童和年轻人的传播。对该年龄段的保护（<35岁）需要在未接种疫苗的个体中观察到群疫苗之前的疫苗接种覆盖率更高。 3）制定基于学校的疫苗接种计划，以快速，及时提供CAIV-T疫苗。以学校为基础的流感疫苗接种计划可以作为控制流感和其他高优先病原体的模型。 4）捕获CAIV-T后许可的安全信息。我们的疫苗接种目标是每年50％的覆盖范围（约8,000名学龄儿童）。将重点放在制定基于学校的疫苗接种计划上。 The trial will be a continuation of the open-labeled, non-randomized, community-based trial in central Texas which includes active viral surveillance in Scott & White clinics in the intervention and comparison communities, disease-based surveillance in Scott & White clinics in the intervention and comparison communities, and an integrated approach with local health department, medical establishment and news media to enhance the public awareness of influenza through dissemination of information to the medical establishment,公众和新闻媒体。