VISION Vaccine Effectiveness Network: Why It Succeeded

With the emergency phase of the 新型冠状病毒肺炎 pandemic behind us, interest has grown in understanding why the VISION Vaccine Effectiveness (VE) Network, launched in 2020 by the Centers for Disease Control and Prevention (CDC), 成功地指导了疫苗政策的决定，并在其他类似的重点行动失败时向美国公众提供了重要信息. Knowing what made this collaborative “virtual network” of 9 integrated U.S. 医疗系统, 由韦斯特协调, 能够快速及时的交货, robust data on vaccine effectiveness (VE) for different population segments, 在不同的现实世界条件下, 加深对新型冠状病毒肺炎的结果和并发症的了解，对于帮助我们在其他病原体出现时抗击它们至关重要.

在整个项目过程中, the VISION network published over 25 papers, both in peer-reviewed journals and in CDC’s Morbidity and Mortality Weekly Report (MMWR). 这些出版物向科学界提供了有关新型冠状病毒肺炎疫苗有效性的最新信息，并为决策者提供了决策所需的数据. In one especially productive period, the network published 14 manuscripts in less than 1 year. 下图显示了在此期间同时发生的所有不同的出版工作.

Seeking insight into the success of the VISION network, 韦斯特求助于这项工作的前线人员——参与VISION网络的9个医疗系统的首席研究员(pi)——以及VISION项目的主管, 韦斯特的莎拉·鲍尔报道, 镜头分割, MS, 英里每小时, 副总统 and Lead Scientific/Epidemiology Advisor.

两年多了, pi监督其组织从电子健康记录(EHRs)和与SARS-CoV-2检测相关的疫苗登记中快速提取数据, 新型冠状病毒肺炎接种疫苗, 冠状病毒样疾病相关医疗事件的临床特征和出院诊断, and patient demographic information. 这是由于合作机构对其数据系统进行了数十年的投资，以便在大流行期间准备好提供高质量的数据.  

一旦聚集, the data were securely transferred to 趣赢平台, 它进行质量检查，并将数据与其他衍生变量(如潜在的医疗条件)合并成分析数据集。. 然后每两周将数据发送给疾病预防控制中心，以告知保护美国人的关键政策并建立资源分配. The 9 sites that submitted data to 趣赢平台 were:

• Baylor Scott and White Health (Texas)
• Columbia University Irving Medical Center (New York)
• 明尼苏达州儿童
• HealthPartners (Minnesota and Wisconsin)
• Intermountain Healthcare(犹他州)
• Kaiser Permanente Northwest (Oregon and Washington)
• 注册律师协会(印第安纳州)
• 科罗拉多大学
• Vanderbilt University Medical Center (Tennessee)

What Contributed to the Network’s Success?

PIs responding to this question pointed to the swift, continuous turnout of high-quality, 真实的数据, the extensive and diverse sample of patients, CDC’s leadership and 趣赢平台’s ability to quickly scale up operations, 协调网站的输出, and provide ongoing technical and analytic support to sites. Specifically, they and others involved in the project described the following factors.

Timely, High-Caliber 真实的数据

“VISION从地理上不同的医疗保健系统中全面收集标准化数据是主要因素之一……,VISION PI说。 Malini B的. DeSilva，医学博士，公共卫生硕士，健康伙伴的研究调查员和旅行和热带医学医生. 通过使用这些标准化数据, 该网络能够利用检测阴性的研究设计及时提供新型冠状病毒肺炎 VE估计.她补充说，不再需要通过图表审查来获取SARS-CoV-2检测呈阳性或阴性的患者的信息，从而实现了“更快的分析”,” which helped guide policy decisions.

Pointing to 趣赢平台’s support, VISION PI Manjusha Gaglani, 黑带大师, FAAP, FIDSA, FPIDS, 贝勒·斯科特和怀特健康公司疫苗和感染研究中心(CRVI)主任, 德州, 他说:“趣赢平台在及时更新数据字典和定期沟通方面的出色配合，为网站提供了及时的反馈，[导致]数据质量的提高。.”

Toan C. Ong，博士，VISION PI和 Associate Professor at the 科罗拉多大学 Anschutz Medical Campus, commented that “despite many challenges, VISION sites never stopped trying to improve the quality of the data, either through internal data exploratory activities or external collaboration with other sites.”

VISION项目主任Ball说，通过制定统一的协议来协调各站点的数据收集和程序，并实施创新的数据管理系统, 趣赢平台 was able to deliver 真实的数据 and real-world evidence.

“及时向政府提供数据对于了解这种疾病的早期流行病学至关重要, 高危人群的VE, and when VE was waning—all of which was necessary to formulating policy decisions,鲍尔说.

不同的样本群体

Were it not for the large sample size of diversified populations, key questions about 新型冠状病毒肺炎’s VE for different groups would not have been possible, 德西尔瓦说. 与此呼应的是， VISION PI Anupam Kharbanda, MD, MSc, Clinical 副总统 and Chief of Critical Care 服务 at 明尼苏达州儿童, added that this diversity—“both in terms of age, 地理位置, 和种族构成”——源于地理上不同的卫生系统的合作——促成了VISION的成功.

Collaboration, Resilience, and Dedication

“VISION是我参与过的要求最高、节奏最快的项目，”Ong说. “Yet our teams in Colorado and all other teams of the VISION sites were resilient, 专用的, and rose to the challenge…to respond to the needs of [delivering] data and scientific expertise.

“我们有一支才华横溢的团队，他们保持专注，不知疲倦地工作，快速分析SARS-CoV-2疫苗有效性数据并传播结果……,加格拉尼说.

“这要归功于疾病预防控制中心鼓励我们与流行病学领域的专家和领导者合作, 传染病, and data science at our collaborating sites,鲍尔说.

疾控中心的领导

CDC’s leadership was unquestionably a factor in the Network’s success, said Ong. 对此进行阐述, Ong解释说，疾病预防控制中心的“果断行动和支持引导项目团队朝着正确的方向应对大流行的紧急情况. CDC’s leadership was stellar,” he exclaimed. “与趣赢平台团队一起，CDC的同事总是尽最大努力明确目标, 数据需求, 数据定义.”

韦斯特的模范支持

“The importance of 趣赢平台’s role as a data coordinating center…cannot be overstated,” said Ong. [The 趣赢平台] team …provided “excellent and unwavering support technically and scientifically. Things ran smoothly and timely because of the professionalism, 礼貌, 以及团队的能力.”

“The 趣赢平台 team was willing to ask important research questions, 探索不同的分析方法, and find innovative solutions to move the epidemiology and VE science forward,加格拉尼指出.

“我们的合作工作有助于疾病预防控制中心了解这种疾病和疫苗的有效性,鲍尔说. “Importantly, our research contributed to decreased morbidity and mortality from 新型冠状病毒肺炎.”