IP21-002, Surveillance for Vaccine Preventable Disease in Children

Component A: Project Summary
Texas Children’s Hospital (TCH) aims to continue inpatient and emergency department surveillance as part
of the larger national New Vaccine Surveillance Network (NVSN) to assess the burden of pediatric
respiratory and gastrointestinal illnesses and acute flaccid myelitis in hospitalized children and children
seeking care in the emergency department. Specifically, we will operate year-round surveillance to assess
the burden of multiple viral and bacterial respiratory pathogens, including but not limited to SARS-CoV-2,
influenza, respiratory syncytial virus, human metapneumovirus, parainfluenza virus, coronavirus, rhinovirus, and
emerging respiratory pathogens, such as enterovirus D68. A concurrent group of healthy, asymptomatic children
presenting to Texas Children’s Pediatric practices for well child care will be enrolled as a control group. Nose
and/or throat swabs will be collected from symptomatic and healthy control children and tested for a wide array
of respiratory pathogens using molecular methods in the laboratory of Dr. Pedro Piedra, a national expert in
pediatric respiratory disease. In addition, we will assess the burden of gastrointestinal pathogens such as
rotavirus and norovirus. Stool specimens from symptomatic patients and healthy control children will undergo
molecular testing in the labs of Dr. Robert Atmar and Dr. Sasirekha Ramani at Baylor College of Medicine.
Complete vaccination histories will be obtained for all children based on our well-established process for
gathering vaccination histories. We will calculate baseline and population-based rates of respiratory and enteric
pathogens among hospitalized and ED patients. Using a test negative study design, we will calculate vaccine
effectiveness for vaccine-preventable diseases such as influenza, rotavirus and SARS-CoV-2, comparing
symptomatic patients who test positive for a pathogen of interest to symptomatic patients and asymptomatic,
healthy controls who test negative for the specific pathogen. Importantly, TCH is an exemplary surveillance
site due the large number of admissions each year (>36,000), racial and ethnic diversity of the Houston
area, and the similarity of the TCH population to that of the community. Given the large number of
admissions per year and depth of local neurologic expertise, TCH represents the ideal site for conducting year-
round surveillance for children with acute flaccid myelitis (AFM) and comparing rates of AFM with rates of
circulating respiratory and gastrointestinal pathogens.

Grant Number: 5U01IP001150-05
NIH Institute/Center: ALLCDC
Principal Investigator: Julie Boom