The goal of the NVSN program is to evaluate the impact
of new vaccines and vaccine policies through a network
of sites in the U.S. The current NVSN sites are affiliated
with the University of Rochester, Vanderbilt University,
and Cincinnati Children’s Hospital Medical Center.
The NVSN sites conduct population-based inpatient and
enhanced outpatient surveillance for vaccine-preventable
disease outcomes, applied epidemiologic and health service
research, and investigator-initiated studies to achieve
the goals of the network.
New Vaccine Surveillance Network (NVSN)
was established in 1999 to evaluate
the impact of new vaccines and vaccine
policies through active sentinel surveillance
at three U.S. medical centers. These
NVSN sentinel sites include the University
of Rochester in Rochester NY, Vanderbilt
University in Nashville Tennessee,
and Cincinnati Children’s Hospital
Medical Center in Cincinnati, Ohio.
The sites conduct population-based
inpatient and enhanced outpatient
surveillance for vaccine-preventable
disease outcomes, applied epidemiologic
and health service research, and investigator-initiated
studies to achieve the goals of the
The program complements existing surveillance programs for vaccine-preventable diseases by conducting seasonal active population-based surveillance for hospitalizations associated with acute respiratory illness (ARI) and acute gastroenteritis (AGE) in children who reside within the counties under NVSN surveillance (Monroe County NY, Davidson County TN, Hamilton County OH). Active surveillance is also conducted in emergency departments and outpatient clinics.
are collected for laboratory testing
for both ARI and AGE surveillance.
ARI specimens are tested using viral
culture and RT-PCR for respiratory
pathogens. The viruses tested depend
on study year and setting and have
included influenza A and B annually
as well as RSV, parainfluenza, human
metapneumovirus, rhinovirus, bocavirus,
and coronaviruses for selected years.
AGE specimens are tested for rotavirus
antigens using an EIA and positive
specimens undergo typing using RT-PCR.
addition to surveillance, the NVSN has
conducted special studies regarding new
vaccines/vaccine recommendations including
vaccine effectiveness, feasibility/KAP
of implementing new vaccine recommendation,
uptake and impact of vaccination with
influenza and pneumococcal conjugate vaccine
(PCV7), and collected data on other childhood
vaccines. Although new vaccines and vaccine
policies have focused on young children
with ARI and AGE, the NVSN is not restricted
to this age group or to respiratory and
enteric pathogens. Future activities may
include other vaccines that are in development.
of Rochester School of
Medicine and Dentistry,
Peter Szilagyi, MD, MPH
Caroline Hall, MD and Geoff
University School of
Marie Griffin, MD, MPH
Allen Staat, MD, MPH
for Disease Control and
Prevention, National Immunization
Officer: Marika Iwane,
Officer: Daniel Payne,
Lauren Stockman, MPH,
and Haley Clayton, MPH
seasonal surveillance of children
<12 years of age hospitalized for
for respiratory viruses in children
<13 years of age with medically-attended
visits for fever/ARI
in emergency departments and outpatient
clinical and other risk factors
for serious ARI outcomes among young
children and disease/risk subgroups.
influenza vaccine effectiveness
in young children.
missed opportunities for influenza
vaccination and impact of new vaccine
recommendations on the childhood
direct and indirect economic costs
of influenza for inpatient and outpatient
care through household interviews and
of implementing expanded recommendations
for influenza vaccination of young
children through surveys, time motion
studies, and database assessment of
visit burden on practices.
the impact of PCV7 on disease burden
in infants and young children using
insurance claims databases.
the impact of PCV7 on the number
of vaccination visits and shots,
delivery of other vaccines, and
provider practices during
the PCV7 shortage in 2001-03 with
provider surveys and chart reviews
in a sample of practices to assess
compliance with vaccine recommendations.
seasonal surveillance for rotavirus
among children <3
years of age hospitalized for
for rotavirus among children
<3 years of age with medically-attended
visits for acute gastroenteritis
in emergency departments
and outpatient practices.
- Characterizing the clinical and epidemiologic factors of children having rotavirus AGE resulting in hospitalizations, emergency department, and outpatient office visits
rotavirus vaccine effectiveness
using both a case-control
and a case-cohort study
serious health outcomes related
to rotavirus gastroenteritis
Note: Supplemental funding from non-CDC
sources provided support for some of
Poehling KA , Edwards KM, Weinberg GA, Szilagyi P, Staat MA, Iwane MK, Bridges CB, Grijalva CG, Zhu Y, Bernstein DI, Herrera G, Erdman D, Hall CB, Seither R, Griffin MR. The underrecognized burden of influenza in young children. N Engl J Med 2006; 6:355(1):31-40.
Influenza Activity -- United States
and Worldwide, 2005-06 Season, and
Composition of the 2006-07 Influenza
Vaccine. Morb Mort Wkly Rep 2006;
Szilagyi PG, Griffin MR, MD, Shone
LP, Bartha R, Zhu Y, Schaffer S, Ambrose
S, Roy H, Poehling KA, MD, Edwards KM,
Walker FJ, Schwartz B, The Impact of
Conjugate Pneumococcal Vaccination on
Routine Childhood Vaccination and Primary
Care Use in 2 Counties. Pediatrics 2006;118;1394-1402.
Grijalva CG, Weinberg GA, Bennett
NM, Staat MA, Craig AS, Dupont WD, Iwane
MK, Postema AS, Schaffner W, Edwards
KM, Griffin MR. Estimating the undetected
burden of influenza hospitalizations
in children. Epidemiol Infect 2006
Grijalva CG , Craig AS, Dupont WD,
Bridges CB, Schrag SJ, Iwane MK, Schaffner
W, Edwards KM, Griffin MR. Estimating
influenza hospitalizations among children. Emerg
Infect Dis 2006 Jan;12(1):103-9.
Update: Influenza Activity -- United
States, 2004-05 Season. Morb Mort
Wkly Rep 2005;54(13);328-331.
Iwane MK, Edwards KM, Szilagyi PG, et al. Population-based surveillance for hospitalizations associated with respiratory syncytial virus, influenza virus, and parainfluenza viruses among young children. Pediatrics 2004;113:1758-64.
Mullins JA, Erdman DD, Weinberg GA, Edwards K, Hall CB, Walker FJ, Iwane
M, Anderson LJ. Human metapneumovirus infection among children hospitalized
with acute respiratory illness. Emerg Infect Dis 2004 Apr;10(4):700-5.
Griffin MR, Walker FJ, Iwane MK, Weinberg GA, Staat MA, Erdman DD. Epidemiology of respiratory infections in young children: insights from the New Vaccine Surveillance Network. Pediatr Infect Dis J 2004;23:Suppl:S188-S192.
Humiston SG , Szilagyi PG, Iwane MK, Schaffer SJ, Santoli J, Shone L, Barth R, McInerny T, Schwartz B. The feasibility of universal influenza vaccination for infants and toddlers. Arch Pediatr Adolesc Med . 2004;158(9):867-74.
KA, Lafleur BJ, Szilagyi PG, Edwards
KM, Mitchel E, Barth R, Schwartz B,
Griffin MR. Population-based impact
of pneumococcal conjugate vaccine
in young children. Pediatrics 2004
GA, Erdman DD, Edwards KM, Hall CB, Walker
FJ, Griffin MR, Schwartz B. Superiority
of Reverse-transcription Polymerase Chain
Reaction to Conventional Viral Culture
in the Diagnosis of Acute Respiratory
Tract Infections in Children. JID
PG, Iwane MK, Schaffer S, Humiston SG,
Barth R, McInerny T, Shone L, Schwartz
B. Potential Burden of Universal Influenza
Vaccination of Young Children on Visits
to Primary Care Practices. Pediatrics
D, Weinberg GA, Edwards KM, Walker FJ,
Anderson B, Winter J, Gonzalez M, Anderson
LJ. GeneScan reverse transcription-PCR
assay for detection of 6 common respiratory
viruses in young children hospitalized
with acute respiratory illness. J
Clin Microbiol 2003; 41:4298-4303.
KA, Szilagyi PG, Edwards K, Mitchel E,
Barth R, Hughes H, LaFleur B, Schaffer
SJ, Schwartz B, Griffin MR. Streptococcus
pneumoniae-related illnesses in young
children: secular trends and regional
variation. Pediatric Infectious Disease
Journal 2003; 22:391-394.
Poehling KA, Szilagyi PG, Edwards
K, Mitchel E, Barth R, Hughes H, Lafleur
B, Schaffer SJ, Schwartz B, Griffin
MR. Streptococcus pneumoniae-related
illnesses in young children: secular
trends and regional variation. Pediatr
Infect Dis J 2003 May;22(5):413-8.
PG, Iwane MK, Humiston SE, Schaffer S,
McInerny T, Shone L, Jennings J, Washington
ML, Schwartz B. Time spent by primary
care practices on pediatric influenza
vaccination visits: Implications for
universal influenza vaccination. Archives
of Pediatrics & Adolescent Medicine
SJ, Szilagyi PG, Shone LP, Ambrose SJ,
Dunn K, Barth RD, Edwards K, Weinberg
GA, Balter S, Schwartz B. Physician Perspectives
regarding Pneumococcal Conjugate Vaccine.
Pediatrics 2002;110(6). http://pediatrics.aappublications.org/cgi/content/full/110/6/e68
Poehling KA, Edwards KM, Weinberg
GA, Staat MA, Iwane MK, Schaffner
W, Griffin MR. Accuracy and interpretation
of rapid influenza tests in children.
Pediatrics (in press).
Miller KE, Lu X , Erdman DD, Poehling KA, Zhu Y, Griffin
MR, Hartert TV, Anderson LJ, Weinberg GA, Hall CB, Iwane
MK, Edwards KM. Rhinovirus Hospitalizations in Young Children.
Journal of Infectious Diseases (in press).
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