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

IF 10.9 1区医学 Q1 INFECTIOUS DISEASES

Clinical Microbiology and Infection Pub Date : 2025-02-01 DOI:10.1016/j.cmi.2024.09.020

Yuanhua Liu , Yang Song , Fengfeng Liu , Yue Chen , Yang Liu , Jin Shi , Ke Li , Yun Yin , Qingqing Liang , Na Liu , Ming Ming , Lei Hua , Qian Shi , Jiayao Xu , Rui Yuan , Shuting Li , Lele Zhang , Yu Zhao , Na Wang , Jidan Zhang , Zhijie Zhang

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引用次数: 0

Abstract

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 real-world 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 (I² = 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 ∼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.

查看原文本刊更多论文

肠道病毒 A71 疫苗对手足口病的疗效：中国的一项实际研究。

目的：为预防手足口病（HFMD），中国自2016年起开始使用肠道病毒A71（EV-A71）疫苗。为了更好地指导疫苗接种策略，我们评估了中国接种 EV-A71 疫苗的实际效果：分析基于中国五岁以下儿童中由 EV-A71 引起的手足口病的监测数据以及气象和人口数据。采用季节自回归综合移动平均模型和间断时间序列分析方法，估计接种EV-A71疫苗对EV-A71手足口病发病率的影响，并预测未接种EV-A71疫苗的反事实病例：2010年至2018年，中国260个城市共报告6 712 613例5岁以下儿童由EV-A71引起的手足口病。2017-2018年期间，接种EV-A71疫苗与EV-A71手足口病发病率下降有关，相对风险为0.83（95%置信区间（CI）：0.81-0.86），估计减少297946（95% CI：250534-346658）例。然而，这种关联在不同城市之间存在差异（I2=85.6%，PConclusions：我们的研究表明，EV-A71 疫苗接种与 EV-A71 手足口病发病率的降低有关，但这种关联因地区而异，并受疫苗接种覆盖率和人口密度的影响。为了更好地预防 EV-A71 手足口病，建议提高五岁以下儿童的疫苗接种率（超过 20%）。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical Microbiology and Infection 医学-传染病学

CiteScore

25.30

自引率

2.10%

发文量

441

审稿时长

2-4 weeks

期刊介绍： Clinical Microbiology and Infection (CMI) is a monthly journal published by the European Society of Clinical Microbiology and Infectious Diseases. It focuses on peer-reviewed papers covering basic and applied research in microbiology, infectious diseases, virology, parasitology, immunology, and epidemiology as they relate to therapy and diagnostics.