Enhanced Surveillance for New Vaccine Preventable Diseases

加强对新疫苗可预防疾病的监测

• 批准号: 10345655
• 负责人: NATASHA Bassam HALASA
• 金额: $ 144.16万
• 依托单位: VANDERBILT UNIVERSITY MEDICAL CENTER
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-09-01 至 2026-08-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10345655
• 关键词: Enhanced; Surveillance; New; Vaccine; Preventable

PROJECT SUMMARY - Mandatory Component A Acute respiratory illness (ARI) and acute gastroenteritis (AGE) are the leading causes of death worldwide in young children. Established leading viral etiologies of AGE are rotavirus and norovirus and respiratory syncytial virus (RSV) and influenza virus for ARI. Our understanding of ARI and AGE epidemiology is constantly changing due to spatiotemporal fluctuations, discovery of new or re-emerging pathogens [e.g. enterovirus D68 (EV-D68) and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)], and use of rotavirus and influenza vaccines. Hence, surveillance efforts are imperative to define ARI and AGE disease burden, causative pathogens, outcomes, and vaccine impact. The primary influenza prevention strategy in the United States is vaccination for all individuals six months or older. There is a paucity of data regarding vaccine effectiveness (VE) against laboratory-confirmed influenza in children, and influenza viruses and vaccine antigenic components change annually. Therefore, perpetual assessments of VE are needed to monitor the impact of influenza vaccination on disease and inform strategies to improve magnitude, durability, and breadth of protection. Pediatric SARS-CoV-2 vaccines are an urgent public-health priority and likely will become available on an accelerated timeline in an effort to curb the COVID-19 pandemic. Rigorous, prospective surveillance of SARS-CoV-2 VE is crucial to support reliance on vaccines as primary prevention. Thus, the first main objective of this project is to conduct population-based active surveillance for respiratory and enteric viral pathogens in pediatric inpatient and emergency department settings and asymptomatic controls. Our team of Vanderbilt investigators is highly experienced in conducting prospective, population- based ARI and AGE surveillance. We propose to conduct ARI and AGE surveillance with the following specific aims: 1) To perform prospective, active surveillance to determine the etiology and burden of inpatient and emergency department (ED) acute viral respiratory and enteric diseases among the pediatric population. 2) To characterize the clinical and epidemiologic factors of pediatric infections (including in asymptomatic children) through active surveillance. 3) To evaluate vaccine effectiveness and impact of vaccines and other interventions (e.g., immunoprophylaxis with antiviral agents or other therapeutics) available or projected to become available during the period of performance. The second main objective of this project is to conduct surveillance and epidemiologic characterization of acute flaccid myelitis syndrome in children. Given the epidemiologic connection between EV-D68 infection and acute flaccid myelitis (AFM), it will be important to conduct rigorous, active, longitudinal surveillance for AFM across multiple consecutive seasons; carefully define AFM clinical spectrum, risk factors, incidence rates, and laboratory parameters; and document local circulation of EV-D68 and other ARI and AGE pathogens coincident with increased AFM occurrence. This work underpins development of preventive, diagnostic, and therapeutic strategies for AFM.

项目摘要 - 强制性组件 A 急性呼吸道疾病（ARI）和急性胃肠炎（AGE）是全球范围内导致死亡的主要原因 年幼的孩子。已确定的 AGE 主要病毒病因是轮状病毒、诺如病毒和呼吸道合胞病毒 病毒 (RSV) 和 ARI 流感病毒。我们对 ARI 和 AGE 流行病学的了解不断 由于时空波动、新的或重新出现的病原体的发现而发生变化[例如肠道病毒D68 （EV-D68）和严重急性呼吸综合征冠状病毒 2（SARS-CoV-2）]，以及轮状病毒和 流感疫苗。因此，必须开展监测工作来确定 ARI 和 AGE 疾病负担， 致病病原体、结果和疫苗的影响。美国流感初级预防策略 各州为所有六个月或以上的人接种疫苗。缺乏有关疫苗的数据 针对实验室确诊的儿童流感以及流感病毒和疫苗的有效性（VE） 抗原成分每年都会发生变化。因此，需要对 VE 进行永久性评估来监测 流感疫苗接种对疾病的影响并为改善程度、持久性和广度的策略提供信息 的保护。儿科 SARS-CoV-2 疫苗是一项紧迫的公共卫生优先事项，很可能会成为 为了遏制 COVID-19 大流行，我们将加速提供。严谨、前瞻 对 SARS-CoV-2 VE 的监测对于支持依赖疫苗作为一级预防至关重要。因此， 该项目的第一个主要目标是对呼吸道和呼吸道疾病进行基于人群的主动监测 儿科住院和急诊室环境中以及无症状的肠道病毒病原体 控制。我们的范德比尔特研究团队在开展前瞻性、人口调查方面拥有丰富的经验。 基于 ARI 和 AGE 的监测。我们建议通过以下具体措施进行 ARI 和 AGE 监测 目标： 1) 进行前瞻性、主动监测，以确定住院患者和患者的病因和负担 急诊科 (ED) 儿科人群中的急性病毒性呼吸道和肠道疾病。 2) 至 描述儿科感染（包括无症状儿童）的临床和流行病学因素 通过主动监视。 3) 评估疫苗的有效性以及疫苗和其他药物的影响 现有或预计的干预措施（例如，使用抗病毒药物或其他治疗方法进行免疫预防） 在演出期间可以使用。该项目的第二个主要目标是进行 儿童急性弛缓性脊髓炎综合征的监测和流行病学特征。给定 EV-D68 感染与急性弛缓性脊髓炎 (AFM) 之间的流行病学联系，重要的是 在连续多个季节对 AFM 进行严格、主动、纵向的监测；小心 定义 AFM 临床谱、危险因素、发生率和实验室参数；并记录本地 EV-D68 和其他 ARI 和 AGE 病原体的循环与 AFM 发生率的增加相一致。这部作品 支持 AFM 预防、诊断和治疗策略的开发。