Abstract
BackgroundIn China, enterovirus 71 (EV71) is the major etiological agents of hand foot mouth disease that poses severe risks to children’s health. Since 2015, three inactivated EV71 vaccines have been approved for use. Previous studies indicated the high willingness of EV71 vaccination in eastern China. However, few studies have assessed coverage and utilization patterns of EV71 vaccine in China.MethodsChildren born during 2012–2018 were sampled and their records were abstracted from Ningbo childhood immunization information management system. Descriptive statistics characterized the study population and assessed coverage and timeliness for EV71 vaccination. Simultaneous administration patterns as well as type of EV71 vaccine used were also evaluated. Bivariate and multivariable analysis was used to examine the relationship of socio-demographic characteristics with vaccination coverage and timeliness.ResultsOf 716,178 children living in Ningbo. One hundred seventy-two thousand two hundred thirty-six received EV71 vaccine with a coverage rate of 24.05% and only 8.61% received vaccination timely. 21.97% of children received the complete two dose EV71 series but only 6.49% completed timely. Vaccination coverage and timeliness increased significantly from 2012 birth cohort to 2018 birth cohort. Relatively higher coverage and timeliness were observed in resident children, Inner districts, high socioeconomic areas and large-scaled immunization clinics. Of 329,569 doses of EV71 vaccine, only 5853(1.78%) doses were administered at the same day as other vaccines.ConclusionsThere is a need for increasing EV71 vaccination coverage and timeliness as well as eliminating disparities among different populations. Our study highlights the importance of simultaneous administration to increasing coverage and timeliness of EV71 vaccination.
Highlights
Hand, foot and mouth disease(HFMD) has been widely considered as a highly infectious exanthematous illness mostly affecting children under 5 years old and has caused substantial burden in Asia [1,2,3], which is characterized with fever, cutaneous lesions on hands, feet, groin and buttocks, as well as painful oral lesions [4]
Historical and current vaccination records should be registered into Ningbo Childhood Immunization Information Management System (NBCIIMS) and updated in real time(including vaccination in Ningbo and the historical vaccination at the clinics out of Ningbo), which provides an ideal tool to make an accurate estimate of the vaccination coverage
In a large sample of children from Ningbo city which is located in economically-advanced eastern China, we found that the overall enterovirus 71 (EV71) vaccination coverage of children was low, even though it was higher than those estimated for coverage reported in Guangdong [21] and Fujian province [20]
Summary
Foot and mouth disease(HFMD) has been widely considered as a highly infectious exanthematous illness mostly affecting children under 5 years old and has caused substantial burden in Asia [1,2,3], which is characterized with fever, cutaneous lesions on hands, feet, groin and buttocks, as well as painful oral lesions [4]. Since there is no effective antiviral treatment for EV71 infection available yet [6, 7], EV71 vaccine has been considered as a promising preventive intervention against EV71-associated HFMD [7, 8]. 2 doses of EV71 vaccine, as a privatesector vaccine that is voluntarily and paid for out-of pocket by parents or caregivers, are recommended by Chinese Center for Disease Prevention and Control (China CDC) to children aged 6–59 months with an interval of month, especially to infants aged 6–12 months for best efficacy [12]. In China, enterovirus 71 (EV71) is the major etiological agents of hand foot mouth disease that poses severe risks to children’s health. Few studies have assessed coverage and utilization patterns of EV71 vaccine in China
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