Core_Apt Measure of PCR-based Influenza Vaccine Effectiveness in Inpatient Adults

Core_Apt 测量基于 PCR 的流感疫苗对住院成人的有效性

• 批准号: 10179286
• 负责人: Manjusha Gaglani
• 金额: $ 50万
• 依托单位: SCOTT AND WHITE MEMORIAL HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2015
• 资助国家: 美国
• 起止时间: 2015-08-01 至 2020-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10179286
• 关键词: Core_Apt; Measure; PCR; based; Influenza

 DESCRIPTION (provided by applicant): Influenza viruses are constantly changing, requiring the reformulation of vaccines every year. Accurately estimating influenza vaccine effectiveness in preventing influenza infection is critical in order to evaluate the protection provided by annua, nationwide vaccination programs. Our long-term goal is to discover more advanced strategies to measure vaccine effectiveness, to potentially reduce the overall burden of influenza infection. The effectiveness of influenza vaccines with the ACIP recommended universal immunization strategy in the Scott and White Memorial Hospital -Temple Population Research Area (SWH-TPRA) adult source population will be systematically investigated. The objective of the proposed work is to explore strategies for measuring vaccine effectiveness against lab-confirmed influenza (VE-LCI) in adult inpatients, including the elderly, who have the highest hospitalization rates. This includes the identification, implementation and evaluation of innovative, feasible, and sustainable strategies for measuring VE-LCI in persons aged 18 years or older in acute inpatient care settings. The central hypothesis is that timely and efficient measurement of VE- LCI in adult inpatients is feasible and sustainable in the U.S. This hypothesis will be tested by pursuing three specific aims: 1) Identify innovative, feasible, and sustainable strategies to measure VE-LCI in a timely and efficient manner for persons ≥ 18 years admitted with an acute respiratory illness (ARI) in acute inpatient care settings, 2) Implement the above strategies to measure VE-LCI for adult inpatients with ARI, and 3) Evaluate the above strategies to measure VE-LCI for adult inpatients with ARI. To achieve these goals, VE-LCI will be determined in adults admitted to SWMH with ARI who test positive for influenza A and/or B by the real-time polymerase chain reaction (RT-PCR) assay. The odds of being vaccinated against influenza for PCR-confirmed cases will be compared to age-matched PCR-negative controls, after adjusting for confounders. During 2015- 2016 through 2019-2020, 300 patients and 800 adults admitted to SWMH with an ARI will be eligible to participate in the BSWH CDC VE-LCI adult inpatient study, respectively. Using a test-negative study design, VE-LCI for adult inpatients with ARI will be measured. Influenza immunization rates will be calculated for the RT-PCR confirmed cases and test negative controls, adjusting VE-LCI for confounders. The approach is innovative because effective measures of the public health impact of increasing influenza immunization on burden of illness will be defined. The proposed research is significant, because it will support improved understanding of timely and efficient measures of VE-LCI, which in turn will support the goal of reducing influenza-associated health burdens.

 描述（由申请人提供）：流感病毒不断变化，需要每年重新配制疫苗，以评估我们的长期全国疫苗接种计划所提供的保护。目标是发现更先进的策略来衡量疫苗的有效性，以潜在地减少流感感染的总体负担。在斯科特和怀特纪念医院-坦普尔人口研究区，采用 ACIP 推荐的普遍免疫策略来降低流感疫苗的有效性。 (SWH-TPRA) 成人来源人群将进行系统调查。拟议工作的目的是探索衡量成人住院患者（包括住院率最高的老年人）实验室确诊流感 (VE-LCI) 疫苗有效性的策略。 这包括确定、实施和评估创新的、可行的和 在急性住院患者中测量 18 岁或以上人群 VE-LCI 的可持续策略 核心假设是，在美国，及时有效地测量成人住院患者的 VE-LCI 是可行且可持续的。该假设将通过追求来检验。三个具体目标： 1) 确定创新、可行和可持续的策略，及时有效地测量急性住院护理机构中 18 岁以上因急性呼吸道疾病 (ARI) 入院的患者的 VE-LCI， 2) 实施上述策略来测量成人急性呼吸道感染住院患者的 VE-LCI，以及 3) 评估上述测量成人急性呼吸道感染住院患者 VE-LCI 的策略 为了实现这些目标，将确定入院成人的 VE-LCI。通过实时聚合酶链式反应 (RT-PCR) 检测呈甲型和/或乙型流感的 SWMH 患有 ARI 的病例将与 PCR 确诊病例感染流感的几率进行比较。调整混杂因素后，年龄匹配的 PCR 阴性对照在 2015-2016 年至 2019-2020 年期间，SWMH 入院的 ARI 患者和 800 名成人将分别有资格参加 BSWH CDC VE-LCI 成人住院患者研究。使用测试阴性研究设计，将计算 ARI 成年住院患者的 VE-LCI。对于 RT-PCR 确诊病例和测试阴性对照，调整 VE-LCI 的混杂因素是创新的，因为将确定增加流感免疫对拟议疾病负担的公共卫生影响的有效措施，因为这项研究意义重大。它将支持加深对 VE-LCI 及时有效措施的了解，从而支持减少流感相关健康负担的目标。