Use of an electronic monitoring system for self-reporting smallpox vaccine reactions.

OBJECTIVES: Tracking vaccine reactions and adverse events during a large-scale vaccination program such as the recent smallpox program or a pandemic flu outbreak will be a challenge. We report on vaccine reaction data collected using a novel telephone- and web-based electronic reporting system. The system was used to monitor vaccinees during the U.S. Army's smallpox vaccination campaign, which was part of the national program to prepare against biological attack. In addition, we report on the time course of events after smallpox vaccination based on the self-reported data and evaluate the validity and reliability of self-reported take information after smallpox vaccination. METHODS: A prospective cohort of subjects receiving the smallpox vaccination volunteered to use an electronic monitoring system to track and report their vaccination reactions. RESULTS: Users made 6.8 +/- 6.2 (mean +/- SD) reports using the electronic monitoring system. The sensitivity and positive predictive value of self-reported takes were high, 98.8% and 99.6%, respectively. The vaccination-site reactions progressed faster for revaccinees than first-time vaccinees. CONCLUSIONS: Simple-to-use telephone/Internet-based technology allowed detailed self-recording of response to smallpox vaccination among outpatients. Self-reports on site appearance were sufficient to determine vaccine takes in most vaccinees. During a mass vaccination event, an electronic monitoring system could facilitate tracking of vaccine reactions, including providing an early warning system for adverse events, and might reduce the burden associated with follow-up visits with healthcare professionals.

Design and operation of the National Asthma Survey.

OBJECTIVES: This report presents detailed information on the National Asthma Survey (NAS), a module of the State and Local Area Integrated Survey program conducted by the Centers for Disease Control and Prevention's (CDC) National Center for Health Statistics. NAS, sponsored by the CDC's National Center for Environmental Health, was designed to produce national prevalence estimates of adults and children with asthma; to describe the health, socioeconomic, behavioral, and environmental predictors that relate to controlling asthma better; and to characterize the content of care and limitations of persons with asthma. National prevalence estimates were constructed to be consistent with those produced from the CDC's National Health Interview Survey (NHIS), although prevalence estimates for subpopulations may or may not be consistent with NHIS. METHODS: Two separate random-digit-dial telephone studies were fielded: a national study and a four-state study in Alabama, California, Illinois, and Texas. Children aged 0-17 years and adults aged 18 years and over were included in both studies. The screening procedure differed between the studies. Percentages can be generated for the four states combined or for each state separately. A substudy was conducted in the national study to examine the accuracy of proxy reports of asthma. RESULTS: Data were collected from February 2003 to March 2004. A total of 955 detailed asthma interviews were completed in the national study and 5,741 in the four-state study. A data file has been released for each study that contains asthma, health, and demographic data, as well as sampling weights. The weighted overall response rates were 47.2% for the national sample and 48.5% for the four-state sample.

Design and Operation of the National Survey of Children's Health, 2003.

Objectives-This report presents the development, plan, and operation of the National Survey of Children's Health(NSCH), a module of the State and Local Area Integrated Telephone Survey, conducted by the Centers for Disease Control and Prevention's(CDC) National Center for Health Statistics. This survey was designed to produce national and State-specific prevalence estimates for a variety of physical, emotional, and behavioral health indicators and measures of children's experiences with the health care system. The survey also includes questions about the family (e.g., parents' health status, stress and coping behaviors, family activities) and about respondents' perceptions of the neighborhoods where their children live. Primary funding for this survey was provided by the Maternal and Child Health Bureau, Health Resources and Services Administration. Additional support was received from the CDC's National Center for Infectious Diseases, using funds provided by the National Vaccine Program Office. Methods-A random-digit-dial sample of households with children under 18 years of age was selected from each of the 50 States and the District of Columbia. One child was randomly selected from all children in each identified household to be the subject of the survey. The respondent was the parent or guardian who knew the most about the child's health and health care. Results-A total of 102,353 interviews were completed from January 2003 to July 2004. The weighted overall response rate was 55.3%. A data file has been released that contains demographic information on the selected child, substantive health and well-being data for the child and his/her family, and sampling weights. Estimates based on the sampling weights generalize to the noninstitutionalized population of children in each State and nationwide.

Design and operation of the National Survey of Children with Special Health Care Needs, 2001.

OBJECTIVES: This report presents the development, plan, and operation of the National Survey of Children with Special Health Care Needs (CSHCN), a module of the State and Local Area Integrated Telephone Survey, conducted by the National Center for Health Statistics, Centers for Disease Control and Prevention. This survey was designed to produce national and State-specific prevalence estimates of CSHCN, describe the types of services that they need and use, and assess aspects of the system of care for CSHCN. This study included two additional modules to provide health care coverage estimates for all children and to collect data on the reasons that low-income uninsured children lack health care coverage. Primary funding for this survey was provided by the Maternal and Child Health Bureau, Health Resources and Services Administration. METHODS: A random-digit-dial sample of households with children under 18 years of age was selected from each of the 50 States and the District of Columbia. Depending on the health care needs of the children in each household, a detailed interview was conducted for one randomly selected child with special needs and a brief health insurance interview was conducted for one randomly selected child without special needs. The respondent was the parent or guardian who knew the most about the child's health and health care. RESULTS: A total of 196,888 household screening interviews were completed from October 2000 to April 2002. This resulted in 38,866 completed special-needs interviews and 176,296 completed health insurance interviews for children without special needs. The weighted overall response rate for special-needs interviews was 61.0%.