VA SHIELD: What’s the Latest?

The global COVID pandemic shed new light on much-needed areas in emerging infectious disease research, one of which was a need for larger and expanded areas of biorepositories.

Answering that call is the Veterans Affairs (VA) Science and Health Initiative to Combat Infectious and Emerging Life-Threatening Diseases (VA SHIELD), which is described on its website as “a comprehensive, secure biorepository of specimens and associated data.” It is available for authorized VA researchers, and some collaborators, “to advance scientific understanding in support of developing diagnostic, therapeutic, and preventative strategies for use in clinical care.”

During a recently held talk on VA SHIELD at ID Week 2024, Lauren Epstein, MD, MS, who is with Atlanta Veterans Affairs Medical Center, updated the audience in attendance on VA SHIELD’s progress in the 4 years since its inception, in fall 2020.

She was part of a panel that included Ariana Paredes-Vincent, MPH, of the Veterans Health Administration; Maria C. Rodriguez-Barradas, MD, of Michael E. DeBakey VAMC and Baylor College of Medicine; Robert A. Bonomo, MD, of Case Western Reserve University/Louis Stokes Cleveland VA Medical Center; Christopher Woods, MD, MPH, of Durham VA Medical Center; Sheldon T. Brown, MD, of James J. Peters VAMC; and Christopher Ogston, a medical student with the Veterans Health Administration.¹

“I think it’s really exciting because it utilizes the strength of the VA, which is that you have a lot of investigators, people who are passionate about making a difference and people that are committed to working with veterans,” Epstein said in an interview with ImPACT after the meeting. “This platform is really connecting investigators and creating this repository that really can have an effect and impact on learning about the next emerging infection…the point of SHIELD is really to use the strength of the VA to create a cohesive collaboration.”

Currently, VA SHIELD has more than 50,000 specimens collected, including COVID, influenza, respiratory syncytial virus, and mpox. Coordinators at each site direct specimen collection and the type of research based on a vetting process.

The strength of this type of collection, Epstein noted, is the potential to conduct “longitudinal sampling. You can do a specific data and specimen collection that you wouldn’t necessarily be able to do just with discarded specimens.”

At ID Week, Epstein discussed the vector-borne awareness work group’s use of these data, which created an interactive database regarding rare infectious diseases leveraging ICD codes. She added she was excited to see the potential for several other projects as well, including one that is looking at antimicrobial-resistant patterns, particularly among Clostridium difficile.

She noted during the discussion that VA SHIELD was borne out of COVID, noting that the pandemic “made a space for it to come together. I think that there was this recognition that this needs to be done, and we need to have this kind of coordinated system.”

Since its inception, 12 collection sites, 2 central biorepositories, and coordinating centers and data hubs have been established across the United States.

According to the VA SHIELD website: “clinical Laboratory staff with relevant specimens...who are willing to be poised to participate in VA SHIELD are strongly encouraged to contact the national office at This email address is being protected from spambots. You need JavaScript enabled to view it. to initiate training and assess readiness.” Site readiness criteria that the website lists includes “support from site-local research and development committees, support from site leadership and personnel, local site budgeting, equipment, and consumable needs, and capacity to support information management systems.”

According to information on the website, VA SHIELD’s “general priority is to develop a comprehensive repository providing access to researchers according to their needs and in line with VA ORD strategic priorities:

• Increase veterans’ access to high-quality clinical trials
• Increase the substantial real-world impact of VA research
• Put VA data to work for veterans
• Actively promote diversity, equity, and inclusion within our sphere of influence
• Build community through VA research.”

Reference

1. Epstein L, Paredes-Vincent A, Rodriguez-Barradas, MC, et al. VA SHIELD: building an interactive dashboard for surveillance of infectious diseases across the Veterans Health Administration, 2000-2023. 383. Presented at: IDWeek 2024; October 16-19, 2024; Los Angeles, CA.