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. 2022 Aug 1;22(1):1468.
doi: 10.1186/s12889-022-13860-z.

Spatial-temporal-demographic and virological changes of hand, foot and mouth disease incidence after vaccination in a vulnerable region of China

Li Huang #  1 , Ting Wang #  2 , Xuxiang Liu  3 , Yuansheng Fu  2 , Sichen Zhang  2 , Qinshu Chu  2 , Tingyue Nie  2 , Houmian Tu  2 , Jian Cheng #  4 , Yinguang Fan #  5
Affiliations

Spatial-temporal-demographic and virological changes of hand, foot and mouth disease incidence after vaccination in a vulnerable region of China

Li Huang et al. BMC Public Health. .

Erratum in

Abstract

Background: 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.

Methods: 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.

Results: 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.

Conclusions: 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.

Keywords: Enterovirus 71; Epidemiology; Hand foot and mouth disease; Vaccine.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Regional distribution of HFMD before and after vaccination in Hefei from 2012 to 2020
Fig. 2
Fig. 2
Temporal changes of HFMD at daily level in Hefei from 2012 to 2020
Fig. 3
Fig. 3
Age proportion of the group aged 0–4 years old with HFMD cases before and after vaccination in Hefei from 2012 to 2020
Fig. 4
Fig. 4
Enteroviruses proportion of HFMD in Hefei from 2012 to 2020
Fig. 5
Fig. 5
Trend in cumulative EV-A71 vaccination compared to EV-A71 or CV-A6 positivity in Hefei from 2016 to 2020
See this image and copyright information in PMC

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