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Huang L, Wang T, Liu X, Fu Y, Zhang S, Chu Q, Nie T, Tu H, Chen J, Fan Y. Spatial-temporal-demographic and virological changes of hand, foot and mouth disease incidence after vaccination in a vulnerable region of China. BMC Public Health 2022; 22:1468. [PMID: 35915424 PMCID: PMC9342842 DOI: 10.1186/s12889-022-13860-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Accepted: 07/22/2022] [Indexed: 11/25/2022] Open
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. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-022-13860-z.
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Affiliation(s)
- Li Huang
- Faculty of Clinical Medicine, Anhui Medical College, Hefei, 230601, Anhui, China
| | - Ting Wang
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, 230032, Anhui, China
| | - Xuxiang Liu
- Hefei Center for Disease Control and Prevention, Hefei, 230061, Anhui, China
| | - Yuansheng Fu
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, 230032, Anhui, China
| | - Sichen Zhang
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, 230032, Anhui, China
| | - Qinshu Chu
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, 230032, Anhui, China
| | - Tingyue Nie
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, 230032, Anhui, China
| | - Houmian Tu
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, 230032, Anhui, China
| | - Jian Chen
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, 230032, Anhui, China.
| | - Yinguang Fan
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, 230032, Anhui, China.
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