Effectiveness of the enterovirus A71 vaccine on hand, foot, and mouth disease: a real-world study in China

被引：7

作者：

Liu, Yuanhua ^{[1
,2
]}

Song, Yang ^{[3
]}

Liu, Fengfeng ^{[3
]}

Chen, Yue ^{[4
]}

Liu, Yang ^{[5
]}

Shi, Jin ^{[1
,2
]}

Li, Ke ^{[1
,2
]}

Yin, Yun ^{[1
,2
]}

Liang, Qingqing ^{[6
]}

Liu, Na ^{[7
]}

Ming, Ming ^{[8
]}

Hua, Lei ^{[9
]}

Shi, Qian ^{[10
]}

Xu, Jiayao ^{[1
,2
]}

Yuan, Rui ^{[1
,2
]}

Li, Shuting ^{[1
,2
]}

Zhang, Lele ^{[1
,2
]}

Zhao, Yu ^{[1
,2
]}

Wang, Na ^{[1
,2
]}

Zhang, Jidan ^{[1
,2
]}

Zhang, Yanping ^{[3
]}

Chang, Zhaorui ^{[3
]}

Zhang, Zhijie ^{[1
,2
]}

机构：

[1] Fudan Univ, Sch Publ Hlth, Dept Epidemiol & Hlth Stat, Shanghai 20003, Peoples R China

[2] Minist Educ, Key Lab Publ Hlth Safety, Shanghai, Peoples R China

[3] Chinese Ctr Dis Control & Prevent, Div Infect Dis, Key Lab Surveillance & Early Warning Infect Dis, Natl Key Lab Intelligent Tracking & Forecasting In, Beijing, Peoples R China

[4] Univ Ottawa, Fac Med, Sch Epidemiol & Publ Hlth, Ottawa, ON, Canada

[5] London Sch Hyg & Trop Med, Fac Epidemiol & Populat Hlth, Dept Infect Dis Epidemiol, London, England

[6] Hlth Informat Ctr, Guilin Ctr Dis Control & Prevent, Guilin, Peoples R China

[7] Suzhou Ctr Dis Control & Prevent, Dept Immunizat Program, Suzhou, Peoples R China

[8] Taian Ctr Dis Control & Prevent, Dept Immunizat Program, Tai An, Peoples R China

[9] Baoji Ctr Dis Control & Prevent, Dept Immunizat Program, Baoji, Peoples R China

[10] Chaoyang Dist Ctr Dis Control & Prevent, Dept Immunizat Program, Beijing, Peoples R China

来源：

CLINICAL MICROBIOLOGY AND INFECTION | 2025年 / 31卷 / 02期

基金：

中国国家自然科学基金;

关键词：

EV-A71; vaccine; Hand; foot; and mouth disease; HFMD; Real word; Vaccine impact; EFFICACY; SAFETY; IMMUNOGENICITY; CHILDREN;

D O I：

10.1016/j.cmi.2024.09.020

中图分类号：

R51 [传染病];

学科分类号：

100401 ;

摘要：

Objectives: For the prevention of hand, foot, and mouth disease (HFMD), enterovirus A71 (EV-A71) vaccines have been used in China since 2016. To better inform vaccination strategies, we assess the realworld effectiveness of EV-A71 vaccination in China. Methods: The analysis was based on surveillance data of HFMD caused by EV-A71 in children under the age of 5 in China, along with meteorological and demographic data. The seasonal autoregressive integrated moving average model and the interrupted time series analysis were used to estimate the effectiveness of the EV-A71 vaccination on the EV-A71 HFMD incidence and to predict the counterfactual cases with no EV-A71 vaccine. Results: Between 2010 and 2018, 6 712 613 cases of HFMD caused by EV-A71 were reported in children under 5 years old in 260 Chinese cities. During 2017-2018, the EV-A71 vaccination was associated with a reduction in EV-A71 HFMD incidence, with a relative risk of 0.83 (95% CI, 0.81-0.86), and an estimated reduction of 297 946 (95% CI, 250 534-346 658) cases. However, this association varied across cities (I-2 = 85.6%, p < 0.001) and the effectiveness of the EV-A71 vaccination decreased as population density increased. Higher vaccination coverage was associated with greater effectiveness of the EV-A71 vaccination and an earlier point in EV-A71 case reduction. Specifically, when the vaccination coverage exceeded similar to 20%, the relative risk was rapidly reduced to below 0.71 (95% CI, 0.69-0.72). Discussion: Our study demonstrated that the EV-A71 vaccination was associated with a reduction in the incidence of EV-A71 HFMD, but the association varied with regions and was influenced by vaccination coverage and population density. To optimize EV-A71 HFMD prevention, increasing vaccination coverage (>20%) is recommended for children under 5 years old. (c) 2024 European Society of Clinical Microbiology and Infectious Diseases. Published by Elsevier Ltd. All rights are reserved, including those for text and data mining, AI training, and similar technologies.

引用

页码：258 / 265

页数：8

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