Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou 511430, Guangdong, China.
Institute of Immunization Program, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou 511430, Guangdong, China.
J Infect. 2022 Oct;85(4):428-435. doi: 10.1016/j.jinf.2022.06.020. Epub 2022 Jun 26.
Enterovirus A71 (EV71) vaccination program was introduced in 2016 in China. Based on a longitudinal surveillance dataset from 2012 to 2019 in Guangdong, China, we estimated the impact of the EV71 vaccination program on hand, foot, and mouth disease (HFMD) incidence, by using a counterfactual prediction made from synthetic control approach integrated with a Bayesian time-series model. We observed a relative reduction of 41.4% for EV71-associated HFMD cases during the post-vaccination period of 2017-2019, corresponding to 26,226 cases averted. The reduction of EV71-associated HFMD cases raised with the elevation of EV71 vaccine coverage by year. We found an indirect effect for the children aged 6-14 years who were less likely to be vaccinated. Whereas, the EV71 vaccine may not protect against non-EV71-associated HFMD. This study provides a template for ongoing public health surveillance of EV71 vaccine effectiveness with a counterfactual study design. Our results show strong evidence of the EV71 vaccination program working on reducing EV71-associated HFMD in real-world settings. The finding will benefit policy-making of EV71 vaccination and the prevention of HFMD.
肠道病毒 A71（EV71）疫苗接种计划于 2016 年在中国推出。基于中国广东 2012 年至 2019 年的纵向监测数据集，我们使用合成控制方法与贝叶斯时间序列模型相结合的反事实预测，估计了 EV71 疫苗接种计划对手足口病（HFMD）发病率的影响。我们观察到，2017-2019 年疫苗接种后，EV71 相关 HFMD 病例相对减少了 41.4%，相当于避免了 26226 例病例。随着 EV71 疫苗覆盖率的逐年提高，EV71 相关 HFMD 病例的减少幅度也有所提高。我们发现，对于不太可能接种疫苗的 6-14 岁儿童，存在间接效应。然而，EV71 疫苗可能无法预防非 EV71 相关的 HFMD。本研究为正在进行的 EV71 疫苗效果的公共卫生监测提供了一个反事实研究设计模板。我们的结果有力地证明了 EV71 疫苗接种计划在现实环境中能够有效降低 EV71 相关 HFMD 的发病率。这一发现将有助于 EV71 疫苗接种和 HFMD 预防的政策制定。
