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Acute Respiratory Illness in Households with Children: Factors associated with Influenza Vaccine Receipt and Viral Interference.

dc.contributor.authorMalosh, Ryanen_US
dc.date.accessioned2015-05-14T16:26:51Z
dc.date.availableNO_RESTRICTIONen_US
dc.date.available2015-05-14T16:26:51Z
dc.date.issued2015en_US
dc.date.submitted2015en_US
dc.identifier.urihttps://hdl.handle.net/2027.42/111513
dc.description.abstractHousehold studies, sometimes referred to as community or family studies, have contributed immensely to our understanding of acute respiratory illnesses (ARI) from identifying causal agents to estimating vaccine effectiveness. The Household Influenza Vaccine Effectiveness (HIVE) study is an ongoing, prospective cohort study of ARI in households with children in the Ann Arbor, Michigan area. This dissertation uses data from years one (2010-2011) through four (2012-2013) of the HIVE Study to address two topics related to the prevention and spread of respiratory viruses in the household setting. First, there has been substantial research on determinants of influenza vaccine receipt in health care workers and pregnant women, but much less in community dwelling adults and children. We used a theoretical framework based on the Health Belief Model to examine the factors associated with influenza vaccine receipt in adults and their children. We found that not only are factors such as perceived benefits and barriers associated with vaccine uptake, but that many of these factors are modified by external motivators, such as doctor recommendation. Second, a phenomenon that has been termed viral interference has been proposed to explain ecologic trends in viral incidence, particularly with respect to influenza and respiratory syncytial virus (RSV). We used two distinct approaches to determine if there was evidence of viral interference across multiple years of HIVE Study surveillance. The first used an ecologic analysis common in the field of economics to examine trends in viral incidences. In addition, we used an individual based approach to examine the risk of influenza after previous ARI. While trends in viral incidences are correlated, we found little consistent evidence for viral interference, though further work is needed. Collectively, this dissertation highlights the value of a prospective cohort study of ARI in the household setting by illustrating the breadth of topics that can be investigated.en_US
dc.language.isoen_USen_US
dc.subjectAcute Respiratory Illnessen_US
dc.subjectVaccine Uptakeen_US
dc.subjectViral Interferenceen_US
dc.titleAcute Respiratory Illness in Households with Children: Factors associated with Influenza Vaccine Receipt and Viral Interference.en_US
dc.typeThesisen_US
dc.description.thesisdegreenamePHDen_US
dc.description.thesisdegreedisciplineEpidemiological Scienceen_US
dc.description.thesisdegreegrantorUniversity of Michigan, Horace H. Rackham School of Graduate Studiesen_US
dc.contributor.committeememberAiello, Allison Elizabethen_US
dc.contributor.committeememberMonto, Arnold S.en_US
dc.contributor.committeememberSanchez, Brisa N.en_US
dc.contributor.committeememberOhmit, Suzanne E.en_US
dc.contributor.committeememberMeza, Rafaelen_US
dc.contributor.committeememberEisenberg, Marisa Cristinaen_US
dc.subject.hlbsecondlevelPublic Healthen_US
dc.subject.hlbtoplevelHealth Sciencesen_US
dc.description.bitstreamurlhttp://deepblue.lib.umich.edu/bitstream/2027.42/111513/1/rmalosh_1.pdf
dc.owningcollnameDissertations and Theses (Ph.D. and Master's)


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