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）每年流感流行有增无减，并造成严重的疾病和经济负担。流感是一种疫苗可预防的疾病。它还被 NIAID 列为高度优先的 C 类新出现/重新出现的传染病威胁，需要寻求其他预防和治疗方法。 1997年至2003年资助的最初拨款“控制流行性流感”的主要目标是评估学龄前和学龄儿童接种流感疫苗通过群体免疫控制流行性流感的潜力。为了实现这一目标，我们对 18 个月至 18 岁的儿童进行了一项开放标签、非随机、基于社区的试验，使用研究性冷适应流感疫苗三价 (CAIV-T)。在该研究的四个疫苗接种年中，我们为 11,096 名儿童注射了 18,780 剂 CAIV-T。这意味着 20-25% 的适龄儿童的年度疫苗接种覆盖率。我们的一些发现是：1) 对成人流感相关疾病的间接有效性（群体免疫）为 8-18%； 2) 儿童单剂量 CAIV-T 与持续至少两个流感季节的显着保护相关，并且 3) CAIV-T 是安全的，与医疗保健利用率的增加无关。此次更新申请的目标是通过对学龄儿童进行 CAIV-T 免疫来控制流行性流感，这可以作为大流行防范和生物防御的一种选择。具体目标是1）通过学龄儿童接种疫苗来控制流感向35岁以上易感成年人的传播。在流感流行期间，成人年龄组可能从群体免疫中受益最多。 2) 控制流感向易感儿童和青少年传播。对该年龄组（<35 岁）的保护需要更高的疫苗接种覆盖率，然后才能在未接种疫苗的个体中观察到群体免疫。 3) 制定以学校为基础的疫苗接种计划，以快速、及时地提供 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度优先病原体的模式。 4) 获取CAIV-T许可后的安全信息。我们的疫苗接种目标是每年 50% 的覆盖率（约 8,000 名学龄儿童）。重点将放在制定基于学校的疫苗接种计划。该试验将是德克萨斯州中部开放标签、非随机、基于社区的试验的延续，其中包括在干预和比较社区的 Scott & White 诊所进行主动病毒监测，在德克萨斯州的 Scott & White 诊所进行基于疾病的监测。干预和比较社区，并与当地卫生部门、医疗机构和新闻媒体采取综合措施，通过向医疗机构、公众和新闻媒体传播信息，提高公众对流感的认识。