Journal of the Pediatric Infectious Diseases Society (JPIDS)
Volume 3 Issue 4 December 2014
http://jpids.oxfordjournals.org/content/current

Case-Control Studies to Assess the Effectiveness of Vaccines
Eugene D. Shapiro
Author Affiliations
Departments of Pediatrics, Epidemiology of Microbial Diseases, and Investigative Medicine, Yale University Schools of Medicine of Public Health and Graduate School of Arts and Sciences, New Haven, Connecticut
Extract
Before a vaccine is approved for general use, its protective efficacy must be demonstrated, usually in a double-blind, randomized clinical trial, the gold standard for scientific validity [1]. Randomization assures lack of bias in allocation of the exposure (vaccine), whereas blinding assures lack of bias in ascertainment of the outcome (infection). Nevertheless, there are a number of disadvantages, both practical and scientific, to randomized clinical trials to assess the efficacy of vaccines [2]. Because large samples and relatively prolonged follow-up may be necessary for adequate statistical power, these studies are extremely expensive. To limit costs, they often are conducted in select populations with an unusually high incidence of the infection of interest. These and other factors, such as the carefully controlled conditions of an experimental study, may lead to questions about the generalizability of the results of such trials to target populations that differ from that in which the trial was conducted. In addition, because clinical trials of experimental vaccines usually are conducted for only a relatively short period, the efficacy of the vaccine over time rarely is assessed…

Vaccination Rates for Measles, Mumps, Rubella, and Influenza Among Children Presenting to a Pediatric Emergency Department in New York City
Philip Zachariah1,2, Amanda Posner1, Melissa S. Stockwell1,2,3, Peter S. Dayan1, F. Meredith Sonnett1, Philip L. Graham1,2,4,5 and Lisa Saiman2,4
Author Affiliations
1Department of Pediatrics, Columbia University Medical Center, and
2Morgan Stanley Children’s Hospital of New York–Presbyterian, Columbia University Medical Center, New York
3Department of Population and Family Health, Columbia University Mailman School of Public Health, New York, New York
4Department of Infection Prevention and Control
5Division of Quality and Patient Safety, New York–Presbyterian Hospital, New York
Abstract
We compared measles, mumps, rubella (MMR), and influenza vaccination rates of children presenting to a Pediatric Emergency Department (PED) in New York City with rates from national assessments. MMR and influenza vaccination rates in this PED population were generally comparable to community rates, but lower than Healthy People 2020 targets.