1. The burden of hand, foot, and mouth disease among children under different vaccination scenarios in China: a dynamic modelling study.
- Author
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Liu Z, Tian J, Wang Y, Li Y, Liu-Helmersson J, Mishra S, Wagner AL, Lu Y, and Wang W
- Subjects
- Child, Preschool, China epidemiology, Female, Hand, Foot and Mouth Disease epidemiology, Humans, Infant, Infant, Newborn, Male, Models, Theoretical, Vaccines, Combined immunology, Enterovirus immunology, Hand, Foot and Mouth Disease prevention & control, Vaccination, Viral Vaccines immunology
- Abstract
Background: Hand, 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., Objective: To predict and compare the incidence of HFMD under different vaccination scenarios in China., Methods: We 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., Results: We 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 R
0 for HFMD in 2015-2018 was 1.08, 1.10, 1.35 and 1.17., Conclusions: Our 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.- Published
- 2021
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