仪征市开展肠道病毒71型灭活疫苗接种对手足口病发病情况的影响

Effect of EV71 Vaccination on the Incidence of HFMD in Yizheng

目的:分析接种肠道病毒71型灭活疫苗(EV71疫苗)对仪征市手足口病发病情况的影响,为下一步制定手足口病防控策略提供参考。方法:对2010—2021年仪征市手足口病发病情况和2017—2021年仪征市EV71疫苗接种情况进行描述性分析。结果:2010—2016年仪征市手足口病年均发病率为255.61/10万,2017—2021年仪征市手足口病年均发病率为164.10/10万,从发病率数据可以看出,开展疫苗接种后,仪征市手足口病发病率明显下降,差异有统计学意义(χ^(2)=638.60,P<0.01)。2010—2021年仪征市报告的14644例手足口病病例中,共有332例为接种EV71疫苗后仍感染手足口病的,其中经实验室确诊24例,未检出EV71感染,说明适龄儿童接种EV71疫苗为手足口病的保护因素,能显著降低儿童EV71病毒的感染风险,差异有统计学意义[OR=1.22,95%CI为(0.17,8.94),χ^(2)=7.93,P<0.01]。所有病例中累计报告重症手足口病病例36例,在已接种EV71疫苗的儿童中未发现重症手足口病病例,但与未接种疫苗的手足口病病例相比,减少重症手足口病的风险并不明显,差异无统计学意义(P>0.05)。结论:为适龄儿童接种EV71疫苗能有效降低其手足口病的发病风险。戴口罩、勤洗手、减少人员聚集等非疫苗干预措施对减少手足口病的发病风险同样效果显著,在日常防控中尤其是低龄幼儿及校园内仍应大力倡导与坚持相关防控措施。随着手足口病病原分布的改变,在巩固EV71疫苗接种率的基础上,还应积极研发推广多价疫苗的使用,以降低其他种类病原带来的手足口病感染和重症手足口病的风险。

OBJECTIVE To analyze the impact of EV71 vaccination on the incidence of Hand-Foot-and-Mouth disease(HFMD)in Yizheng,and to provide reference for the disease prevention and control measures.METHODS Descriptive analysis was used on the incidence of HFMD from 2010 to 2021 and EV71 vaccination started from 2017 to 2021.RESULTS The average annual incidence rate was 255.61/100000 from 2010 to 2016,and the rate became 164.10/100000 from 2017 to 2021,which decreased significantly after the vaccination(χ^(2)=638.60,P<0.01).Among 14644 cases,332 children became ill after vaccination,of which 24were laboratory-confirmed,and no EV71 infection was detected.Vaccination reduced the risk of EV71 infection significantly[OR(95%CI)=0.12(0.02-0.89),χ^(2)=7.93,P<0.01].A total of 36 severe cases were reported in all cases,and none of the vaccinated children had severe cases,but compared with unvaccinated cases,the reduction in the risk of severe cases was not significant.CONCLUSION Vaccination with EV71 can effectively reduce the risk of HFMD.Non-vaccine interventions such as wearing masks,washing hands frequently,and reducing crowd gatherings are also effective in reducing the incidence,and should be vigorously advocated in daily prevention,especially among young children and in schools.As the distribution of pathogens changes,on the basis of consolidating the EV71 vaccination rate,use of multivalent vaccines should also be actively developed and promoted to reduce the risk of HFMD infection caused by other pathogens.