Abstract
BackgroundHand, foot, and mouth disease (HFMD) is a common illness in young children. A monovalent vaccine has been developed in China protecting against enterovirus-71, bivalent vaccines preventing HFMD caused by two viruses are under development.ObjectiveTo predict and compare the incidence of HFMD under different vaccination scenarios in China.MethodsWe developed a compartmental model to capture enterovirus transmission and the natural history of HFMD in children aged 0–5, and calibrated to reported cases in the same age-group from 2015 to 2018. We compared the following vaccination scenarios: different combinations of monovalent and bivalent vaccine; a program of constant vaccination to that of pulse vaccination prior to seasonal outbreaks.ResultsWe estimate 1,982,819, 2,258,846, 1,948,522 and 2,398,566 cases from 2015 to 2018. Increased coverage of monovalent vaccine from 0 to 80% is predicted to decrease the cases by 797,262 (49.1%). Use of bivalent vaccine at an 80% coverage level would decrease the cases by 828,560. Use of a 2.0× pulse vaccination for the bivalent vaccine in addition to 80% coverage would reduce cases by over one million. The estimated R0 for HFMD in 2015–2018 was 1.08, 1.10, 1.35 and 1.17.ConclusionsOur results point to the benefit of bivalent vaccine and using a pulse vaccination in specific months over routine vaccination. Other ways to control HFMD include isolation of patients in the early stage of dissemination, more frequent hand-washing and ventilation, and better treatment options for patients.
Highlights
Hand, foot, and mouth disease (HFMD) is a common infectious disease mainly caused by various enteroviruses
Our results point to the benefit of bivalent vaccine and using a pulse vaccination in specific months over routine vaccination
There are more than 20 types of enterovirus leading to HFMD and Enterovirus 71 (EV71) and Coxsackie virus A16 (CV-A16) are the most commonly reported [3]
Summary
Foot, and mouth disease (HFMD) is a common infectious disease mainly caused by various enteroviruses. HFMD usually affects children under age of five, with a incidence rate of approximately 2400 cases per 100,000 in 2018 in China [1, 2], and occurs more often in children under three [3]. HFMD is usually self-limiting, it can result in complications associated with the central nervous system or death once progressing to severe cases [5, 6]. EV71 accounts for 70% severe HFMD cases and 90% HFMD-related deaths in mainland China [7]. Foot, and mouth disease (HFMD) is a common illness in young children. A monovalent vaccine has been developed in China protecting against enterovirus-71, bivalent vaccines preventing HFMD caused by two viruses are under development
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