Faculty of Clinical Medicine, Anhui Medical College, Hefei, 230601, Anhui, China.
Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, 230032, Anhui, China.
BMC Public Health. 2022 Aug 1;22(1):1468. doi: 10.1186/s12889-022-13860-z.
The enterovirus 71 (EV-A71) vaccine has been used in Hefei for several years, and the epidemiological significance of vaccination in this area is unclear. We aims to explore the spatial-temporal-demographic and virological changes of hand, foot and mouth disease (HFMD) after vaccination in China.
The data for HFMD from 2012 to 2020 were downloaded with the help of HFMD reporting system of Hefei Center for Disease Control and Prevention and combined with the EV-A71 vaccination status in Hefei. The study defined the period between 2012 to 2016 as the pre-vaccination period and explored the effect of vaccination on the incidence of HFMD by comparing the changes of HFMD before and after vaccination in terms of spatial, temporal, demographic and virological aspects.
During the study period, a higher incidence occurred in urban area and the random distribution changed to a slight cluster after vaccination. HFMD incidence had inconsistent seasonality over years, with one or two incidence peaks in varying years. The morbidity decreased from 215.22/105 in 2012-2016 to 179.81/105 in 2017-2020 (p < 0.001). Boys, 0-4 years old children and Scattered children were more susceptible to HFMD compared with the others, the proportions decreased after vaccination except in Scattered children. The main pathogenic enterovirus gradually changed from EV-A71 to Other Enteroviruses, especially coxsackieviruses A6 (CV-A6) after the implementation of EV-A71 vaccination.
The EV-A71 vaccine was effective in reducing the incidence of HFMD and changing the spatial, temporal, demographic, and virological characteristic. These changes should be considered during the vaccination implementation to further reduce the disease burden of HFMD.
肠道病毒 71 型（EV-A71）疫苗已在合肥使用多年，但该地区疫苗接种的流行病学意义尚不清楚。本研究旨在探索中国接种 EV-A71 疫苗后手足口病（HFMD）的时空人群和病毒学变化。
在合肥市疾病预防控制中心 HFMD 报告系统的帮助下，下载了 2012 年至 2020 年的 HFMD 数据，并结合合肥的 EV-A71 疫苗接种情况。本研究将 2012 年至 2016 年定义为疫苗接种前时期，并通过比较疫苗接种前后 HFMD 在空间、时间、人口统计学和病毒学方面的变化，探讨疫苗接种对 HFMD 发病率的影响。
研究期间，城区发病率较高，接种后随机分布变为轻微聚集。HFMD 发病率多年来季节性不一致，不同年份有 1 或 2 个发病高峰。发病率从 2012-2016 年的 215.22/105 降至 2017-2020 年的 179.81/105（p<0.001）。与其他人群相比，男孩、0-4 岁儿童和散居儿童更容易患 HFMD，接种后除散居儿童外，这些人群的比例均有所下降。主要病原体肠道病毒逐渐从 EV-A71 转变为其他肠道病毒，尤其是柯萨奇病毒 A6（CV-A6），这是在实施 EV-A71 疫苗接种后发生的。
EV-A71 疫苗对接种地区 HFMD 的发病率降低和流行特征的改变是有效的。在实施疫苗接种时应考虑这些变化，以进一步降低 HFMD 的疾病负担。
