Early evidence of inactivated enterovirus 71 vaccine impact against hand, foot, and mouth disease in a major center of ongoing transmission in China, 2011-2018: a longitudinal surveillance study

摘要: Background Enterovirus 71 (EV71) is a major causative agent of hand, foot, and mouth disease (HFMD), associated with severe manifestations the disease. Pediatric immunization inactivated EV71 vaccine was initiated in 2016 Asia-Pacific Region, including China. We analyzed time series HFMD cases attributable to EV71, coxsackievirus A16 (CA16), other enteroviruses Chengdu, transmission center China, assess early impacts immunization. Methods Reported were obtained from China's notifiable surveillance system. compared observed post-vaccination incidence rates during 2017-18 counterfactual predictions made negative binomial regression random forest model fitted pre-vaccine years (2011-15). fit change point full evaluate whether trend changed following vaccination. Results Between 2011-18, 279,352 reported study region. The average rate 2017-2018 60% (95% prediction interval (PI): 41%-72%) lower than predicted absence immunization, corresponding an estimated 6,911 PI: 3,246, 11,542) averted over two years. There 52% 0.42, 0.60) fewer predicted. However, non-CA16 non-EV71 elevated 2018. identified significant decline four months into post-vaccine period. Conclusions provide first real-world evidence that programmatic vaccination against effective childhood present approach detect impact or intended consequences data.