Outpatient VE for seasonal flu, pandemic flu and RSV in a large, diverse network

大型、多样化的网络中针对季节性流感、大流行性流感和 RSV 的门诊 VE

• 批准号: 10196884
• 负责人: RICHARD K ZIMMERMAN
• 金额: $ 50万
• 依托单位: UNIVERSITY OF PITTSBURGH AT PITTSBURGH
• 依托单位国家: 美国
• 财政年份: 2016
• 资助国家: 美国
• 起止时间: 2016-08-01 至 2020-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10196884
• 关键词: Outpatient; VE; seasonal; flu; pandemic

Influenza, respiratory syncytial virus (RSV) and human metapneumovirus (HMPV) continue to be major health burdens, each year causing millions of illnesses and tens of thousands of hospitalizations & deaths in the U.S. Although designed to reduce this burden, influenza vaccine has variable effectiveness (VE) from year to year due to host factors, environment, and virus & vaccine characteristics. Data from the US Flu VE Network helps CDC to evaluate vaccine policy, WHO to select vaccine strains and clinicians to use antivirals. We propose a test-negative case-control (TNCC) study to determine influenza VE in UPMC, which serves diverse populations in 500 clinical sites. UPMC wins awards as one of the most wired health systems in the U.S. UPMC preferentially uses high-dose vaccine for persons >65 years, routinely records vaccination status in its electronic medical record and has a two-way interface with the state immunization registry. Our proposal has a strong foundation of current participation in the US Flu VE Network with a multidisciplinary research team with the highest follow-up survey completion rate and enrollment numbers exceeding requirements. Our award-winning, high-throughput lab proposes analyses of influenza, RSV and HMPV. Each virus season definition is supported by >14,000 clinical multiplex respiratory virus tests and ongoing syndromic surveillance. We add agent-based modeling at the Pittsburgh Supercomputer Center. We are a CDC inpatient VE network site, thus we can compare VE for outpatients and inpatients. Specific aims include: 1) Using TNCC methods, determine annual influenza and RSV (after licensure) VE against laboratory-confirmed, medically-attended, acute respiratory infections among outpatients in 3 age groups: 6 mos.-18 yrs., 19-49 yrs., and >50 yrs.; 2) Determine the annual, population-based burden of influenza, RSV and hMPV in the same age groups, using the participating primary care sites as the source population, conduct sensitivity analyses and agent-based modeling on the impact of vaccination options; 3) Prepare for studies related to an influenza pandemic, describing the epidemiology, effectiveness of antivirals and/or pandemic vaccines, including pilot studies on patient portal/phone enrollment.

流感、呼吸道合胞病毒（RSV）和人类偏肺病毒（HMPV）继续 承担重大健康负担，每年都会导致数百万疾病和数万疾病 美国的住院和死亡人数虽然旨在减轻这种负担，但流感 由于宿主因素、环境和影响，疫苗的有效性 (VE) 每年都有变化。 病毒和疫苗特征。来自美国 Flu VE 网络的数据帮助 CDC 评估 疫苗政策、世卫组织选择疫苗株和临床医生使用抗病毒药物。 我们提出一项测试阴性病例对照 (TNCC) 研究，以确定 UPMC 中的流感 VE， 为 500 个临床中心的不同人群提供服务。 UPMC 荣获奖项最多的大学之一 美国的有线医疗系统 UPMC 优先为 65 岁以上的人使用高剂量疫苗 年，定期在其电子病历中记录疫苗接种状况，并具有双向 与国家免疫登记处的接口。 我们的提案为当前参与美国流感 VE 网络奠定了坚实的基础， 跟踪调查完成率和入学率最高的多学科研究团队 数量超出要求。我们屡获殊荣的高通量实验室提出分析 流感、RSV 和 HMPV。每个病毒季节的定义均得到超过 14,000 个临床数据的支持 多重呼吸道病毒检测和持续的症状监测。我们添加基于代理的 匹兹堡超级计算机中心的建模。我们是 CDC 住院 VE 网站， 因此我们可以比较门诊患者和住院患者的 VE。 具体目标包括： 1) 使用 TNCC 方法，确定每年的流感和 RSV（在 许可证）VE 针对实验室确诊的、就医的急性呼吸道感染 门诊患者分为3个年龄组：6岁-18岁、19-49岁和>50岁； 2）确定 同一年龄组中每年基于人群的流感、RSV 和 hMPV 负担，使用 参与初级保健站点作为源人群，进行敏感性分析并 基于代理的疫苗接种方案影响建模； 3) 为相关研究做准备 流感大流行，描述流行病学、抗病毒药物的有效性和/或大流行 疫苗，包括对患者门户/电话登记的试点研究。