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上海市浦东新区灭活A71疫苗对手足口病发病率影响的分析

Analysis of the Impact of Inactivated A71 Vaccine on the Incidence of Hand-Foot-Mouth Disease in Pudong New Area, Shanghai.

作者信息

Yang Dandan, Liu Wenmin, Wang Weiping, Deng Pengfei, Ye Chuchu, Yang Laibao, Xue Caoyi

机构信息

Shanghai Pudong New Area Center for Disease Control and Prevention, Shanghai 200136, China.

出版信息

Vaccines (Basel). 2024 Aug 26;12(9):962. doi: 10.3390/vaccines12090962.

Abstract

The aim of this study was to investigate the level of inactivated A71 (EV-A71) vaccination in Pudong New Area of Shanghai and its effects on the epidemiology and pathogen spectrum of hand-foot-mouth disease (HFMD) in this area, as well as to provide a basis for improving the prevention and control strategy of HFMD in this area. Data were collected from the "Comprehensive Management Cloud Platform for Immunization Program" system from December 2016 to December 2022. The data on HFMD cases from January 2012 to December 2022 were extracted from the "China Information System for Disease Control and Prevention". A total of 484,056 doses were administered. The vaccination rate of the first dose was 14.03%, and the full vaccination rate was 13.33%. There were significant differences between the first dose and the full vaccination rate in different years ( = 46,538.831, < 0.001, = 50,013.946, < 0.001). A total of 91625 cases of HFMD were reported, including 58 severe cases, and no deaths. Before and after the administration of the inactivated EV-A71 vaccine, there were statistical differences in the distribution of HFMD cases in terms of gender, household registration, occupation, and age ( < 0.001). The etiological surveillance results showed that the rate of enterovirus positivity was 84.15%, with 9.85% being EV-A71, 23.74% CV-A16, and 50.56% non-EV-A71 and non-CV-A16. The coverage rate of the inactivated EV-A71 vaccine in Pudong New Area was not high, and the incidence of HFMD showed a downward trend after the postmarketing of the vaccine. The majority of HFMD infections were non-EV-A71 and non-CV-A16, with CV-A6 accounting for the highest proportion. It is recommended to accelerate the development of combined vaccines to provide more antibody protection.

摘要

本研究旨在调查上海市浦东新区灭活肠道病毒71型(EV-A71)疫苗接种水平及其对该地区手足口病(HFMD)流行病学和病原谱的影响,为完善该地区手足口病防控策略提供依据。数据收集自2016年12月至2022年12月的“免疫规划综合管理云平台”系统。2012年1月至2022年12月手足口病病例数据从“中国疾病预防控制信息系统”提取。共接种484,056剂。首剂接种率为14.03%,全程接种率为13.33%。不同年份首剂接种率与全程接种率存在显著差异(χ² = 46,538.831,P < 0.001,χ² = 50,013.946,P < 0.001)。共报告手足口病病例91,625例,其中重症58例,无死亡病例。灭活EV-A71疫苗接种前后,手足口病病例在性别、户籍、职业和年龄分布方面存在统计学差异(P < 0.001)。病原学监测结果显示,肠道病毒阳性率为84.15%,其中EV-A71占9.85%,柯萨奇病毒A16(CV-A16)占23.74%,非EV-A71和非CV-A16占50.56%。浦东新区灭活EV-A71疫苗接种覆盖率不高,疫苗上市后手足口病发病率呈下降趋势。手足口病感染以非EV-A71和非CV-A16为主,其中CV-A6占比最高。建议加快联合疫苗研发,提供更多抗体保护。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2360/11435847/421a6763b0b4/vaccines-12-00962-g001.jpg

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