PittVax

Overview

The PittVax mission statement:   Protecting people—vaccine policy to practice.

The PittVax team is the primary research group of the University of Pittsburgh’s Department of Family Medicine.  Under the leadership of Richard K. Zimmerman, MD, MPH, MA, and Mary Patricia Nowalk, PhD, RDN, PittVax brings together a diverse group of investigators, data specialists, and research assistants.  

Together, the team has conducted studies with funding from more than 60 federal, foundation, and industry-sponsored grants, including: 

• health services and survey research on barriers to childhood and adult vaccinations
• immunological response to influenza vaccine
• intervention studies and randomized cluster trials to increase vaccination rates
• intervention studies and clinical trials of the HPV vaccine
• barriers to standing-order protocols in primary care
• computational modeling studies to determine cost-effectiveness of proposed vaccination strategies

In addition, through its practice improvement research, the PittVax team has created the 4 Pillars™ Practice Transformation Program. The 4 Pillars Program has been tested in a randomized cluster controlled trial, was used as a quality improvement Maintenance of Certification program for physicians and was used in UPMC outpatient sites to support a quality improvement project for adult immunizations.

Since 2011, the PittVax team has been one of five sites for the CDC’s ongoing US Influenza Vaccine Effectiveness Network. Data from the yearly study of influenza vaccine effectiveness are one of the leading drivers of national influenza vaccination policy and recommendations. 

Team 

Projects 

COVID-19

Because of the novelty of the SARSCoV2 (the virus responsible for COVID-19), there was uncertainty about which patients should receive testing, especially in situations of testing shortages. Early in the pandemic,  screening criteria were based on symptoms typically observed in inpatients; however, symptoms among outpatients may not be the same. To understand these differences, our team studied the symptoms reported by outpatients receiving COVID-19 tests. During April 2020, the team collected demographic and symptom data from patients ages 18-87 years. Of these participants, 736 were tested, and 55 were positive for SARS-CoV2. The positive group frequently reported chills, loss of taste/smell, diarrhea, fever, nausea/vomiting and contact with a COVID-19 case, but less frequently reported shortness of breath and sore throat. Based on these results, a decision tree was developed that could help to rule out COVID-19 without the need for testing. In fact, answering several simple questions could identify those persons who are very unlikely to have contracted COVID-19—thus saving both limited testing resources and time.  

US Flu Vaccine Effectiveness Network (FluVE)

Since 2009, the Centers for Disease Control and Prevention (CDC) has researched the seasonal spread of influenza, as well as determining the value of a yearly flu shot. These studies measure the flu vaccine’s ability to prevent outpatient medical visits due to laboratory-confirmed influenza. PittVax, part of The University of Pittsburgh School of Medicine’s Department of Family Medicine, is one of five national sites that form the US Flu Vaccine Effectiveness Network (FluVE). Team members collect samples and provide both data and analyses to help the CDC determine (1) the severity of each year’s flu season; (2) the prevalence of various flu strains; and (3) the level of protection provided by the flu vaccine. These studies are instrumental in refining both our understanding of influenza and in optimizing the annual flu vaccine. 

Hospitalized Adult Influenza Vaccine Effectiveness Network (HAIVEN)

The US Centers for Disease Control DC works with researchers at four universities and hospitals to help measure the flu vaccine’s effectiveness at preventing hospitalizations due to influenza. The University of Pittsburgh School of Medicine’s Department of Family Medicine is one of f the HAIVEN sites. PittVax team members help to collect respiratory specimens and analyze data from adults who are hospitalized with acute respiratory illness.

Influenza Vaccine Immunogenicity Project

The PittVax team has undertaken influenza immunogenicity studies which vary by vaccine type and target population.  The team has compared the immunological response to high dose vaccine vs. standard dose vaccine among frail elderly residents of nursing homes.  They have followed a cohort of middle aged and older community dwelling adults for several years, examining immunological response to annual seasonal influenza vaccine.   Another study is underway comparing immunological response to LAIV or IIV influenza vaccine among children ≥4- years of age.