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Wang J, Zhang S. Epidemiological characteristics and trends of hand-foot-mouth disease in Shanghai, China from 2011 to 2021. Front Public Health 2023; 11:1162209. [PMID: 37325298 PMCID: PMC10267978 DOI: 10.3389/fpubh.2023.1162209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Accepted: 05/09/2023] [Indexed: 06/17/2023] Open
Abstract
Hand, foot and mouth disease (HFMD) is a kind of infectious disease caused by enterovirus infection. In this study we analysed the epidemiological characteristics and time trends of HFMD, vaccination status and vaccine protection effect assessment of EV71 vaccine from 2011 to 2021 in Huangpu District, Shanghai, China. HFMD cases showed a decreasing trend year by year from 2011 to 2021, from 122 cases reported in 2012 to 7 cases in 2020, and 12 cases in 2021. Etiological diagnosis was CV-A6 in 185 cases (29.8%), CV-A16 in 209 cases (33.7%), EV-A71 in 118 cases (19.0%) and other enteroviruses in 109 cases (17.6%). After the launch of EV71 vaccine, a total of 32,221 doses of EV71 vaccine were administered between 2016 and 2021. The case-control results showed that there was no evidence to support the effectiveness of EV71 vaccine, OR (95% CI) =0.52 (0.12 ~ 2.3), p = 0.37. The epidemic strains have changed. Surveillance and management of HFMD remain very important in the future and EV71 vaccine is considered to be included in National Immunization Program.
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Zhao Z, Liao Y, Li Y, Jiang G, Huang Z, Yang H, Ou Z, Yin Q, Chen J, Deng Y, Jiang R, Che Y, Li Q, Zheng H, Zhang J. Immunogenicity and safety of the inactivated enterovirus 71 vaccine administered concomitantly with the measles-rubella vaccine in infants aged 8 months in China: A noninferiority randomized controlled trial. Vaccine 2022; 40:4709-4715. [PMID: 35753838 DOI: 10.1016/j.vaccine.2022.06.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Revised: 06/02/2022] [Accepted: 06/07/2022] [Indexed: 11/28/2022]
Abstract
BACKGROUND To evaluate the immunogenicity and safety of simultaneous administration of the enterovirus 71 (EV71) vaccine with the measles and rubella (MR) combined vaccine. METHODS In this phase 4, randomized, open-label and noninferiority study, a total of 680 infants aged 8 months were enrolled and assigned to the simultaneous administration group (infants received the first dose of EV71 vaccine and MR vaccine on Day 0, and the second dose of EV71 vaccine on Day 28), or the separate administration groups (EV71 group: infants received two doses of EV71 vaccine on Day 0 and Day 28, respectively; MR group: infants received MR vaccine on Day 0). Blood sample was obtained on Day 0 and Day 56 to measure antibody responses to each of the antigens in terms of antibody titer or concentration, respectively. Local and systemic adverse reactions (ARs) and other adverse events (AEs) following each dose were monitored and compared among groups. RESULTS After vaccination, simultaneous administration group showed similar seroconversion rates of antibody against EV71(97.9%), measles (97.4%), and rubella (94.3%) compared to EV71 group (99.6% for anti-EV71) or MR group (98.4% for anti-measles and 98.9% for anti-rubella, respectively). Noninferiority was demonstrated for all antibodies as the lower limits of two-sided 97.5% confidence intervals (CIs) of the difference in seroconversion rates between simultaneous administration group and separate administration groups were above the predefined margin of -10%. Additionally, the adverse reaction rates were comparable among groups (54.4% in the simultaneous group versus 43.9% in the MR group versus 52.6% in the EV71 group). CONCLUSION Antibody responses induced by simultaneous administration of EV71 vaccine with MR vaccine were robust and noninferior to those by single administration alone. Like the previous findings by single administration alone, simultaneous administration demonstrated comparable reactogenicity and safety profiles.
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Affiliation(s)
- Zhimei Zhao
- Institute of Medical Biology, Chinese Academy of Medical Sciences and Peking Union Medical College, Kunming, Yunnan 650118, China
| | - Yuyi Liao
- Guangdong Provincial Institute of Biological Products and Materia Medica, Guangzhou, Guangdong 510440, China
| | - Yuan Li
- Guangdong Provincial Institute of Biological Products and Materia Medica, Guangzhou, Guangdong 510440, China; NMPA Key Laboratory for Technology Research and Evaluation of Pharmacovigilance, Guangzhou, Guangdong 510315, China
| | - Guorun Jiang
- Institute of Medical Biology, Chinese Academy of Medical Sciences and Peking Union Medical College, Kunming, Yunnan 650118, China
| | - Zhuhang Huang
- Guangdong Provincial Institute of Biological Products and Materia Medica, Guangzhou, Guangdong 510440, China
| | - Huijuan Yang
- Institute of Medical Biology, Chinese Academy of Medical Sciences and Peking Union Medical College, Kunming, Yunnan 650118, China
| | - Zhiqiang Ou
- Guangdong Provincial Institute of Biological Products and Materia Medica, Guangzhou, Guangdong 510440, China
| | - Qiongzhou Yin
- Institute of Medical Biology, Chinese Academy of Medical Sciences and Peking Union Medical College, Kunming, Yunnan 650118, China
| | - Junhu Chen
- Guangdong Provincial Institute of Biological Products and Materia Medica, Guangzhou, Guangdong 510440, China
| | - Yan Deng
- Institute of Medical Biology, Chinese Academy of Medical Sciences and Peking Union Medical College, Kunming, Yunnan 650118, China
| | - Ruiju Jiang
- Institute of Medical Biology, Chinese Academy of Medical Sciences and Peking Union Medical College, Kunming, Yunnan 650118, China
| | - Yanchun Che
- Institute of Medical Biology, Chinese Academy of Medical Sciences and Peking Union Medical College, Kunming, Yunnan 650118, China.
| | - Qihan Li
- Institute of Medical Biology, Chinese Academy of Medical Sciences and Peking Union Medical College, Kunming, Yunnan 650118, China.
| | - Huizhen Zheng
- Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, Guangdong 511430, China.
| | - Jikai Zhang
- Guangdong Provincial Institute of Biological Products and Materia Medica, Guangzhou, Guangdong 510440, China; NMPA Key Laboratory for Technology Research and Evaluation of Pharmacovigilance, Guangzhou, Guangdong 510315, China.
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Zhang L, Jin P, Wei M, Jiang H, Li J, Zhu F. A comparison of the test-negative and the matched case-control study designs for estimation of EV71 vaccine immunological surrogate endpoints from a randomized controlled trial. Hum Vaccin Immunother 2022; 18:2073751. [PMID: 35678636 PMCID: PMC9481104 DOI: 10.1080/21645515.2022.2073751] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Since TND could be an appropriate method to assess vaccine effectiveness, we want to know whether it may be used for the estimation of vaccine immunological surrogate endpoints, like case-control study. We conducted two study designs (test-negative design (TND) VS matched case-control design (MCC)) to evaluate immunological surrogate endpoint against EV71-associated diseases. We calculated sensitivity (proportion of participants with EV71-associated disease who have a titer less than the cutoff at day 56), specificity (proportion of matched controls who have a titer equal or greater than the cutoff at day 56), and corresponding Youden index ([sensitivity + specificity] − 1). Then, we compared them between TND and MCC. In test-negative design, we totally enrolled 7029 subjects, 49 tested positive as cases and 6980 tested negative as controls in per-protocol population. In matched case-control design, we totally enrolled 305 subjects, 51 as cases, and 254 as controls in whole cohort. In sensitivity and specificity comparison, TND and MCC’s results were similar to each other, except for a titer of 1:4. Nonetheless, in Youden index comparison, MCC’s results were slightly higher than the TND’s, except for a titer of 1:4. EV71 vaccine immunological surrogate endpoints derived from TND was similar to MCC’s. Our results supported that TND could become an alternative research design with the progress of surveillance.
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Affiliation(s)
- Li Zhang
- Public Health Department, Jiangyin County Center for Disease Control and Prevention, Wuxi, PR China
| | - Pengfei Jin
- Vaccine Clinical Evaluation Department, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, PR China
| | - Mingwei Wei
- Vaccine Clinical Evaluation Department, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, PR China
| | - Hudachuan Jiang
- Schoool of Public Health, Southeast University, Nanjing, PR China
| | - Jingxin Li
- Vaccine Clinical Evaluation Department, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, PR China.,Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, PR China.,Institute of Global Health and Emergency Pharmacy, China Pharmaceutical University, Nanjing, PR China
| | - Fengcai Zhu
- Schoool of Public Health, Southeast University, Nanjing, PR China.,Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, PR China.,Institute of Global Health and Emergency Pharmacy, China Pharmaceutical University, Nanjing, PR China.,NHC Key laboratory of Enteric Pathogenic Microbiology, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, PR China
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Liu X, Yang W, Zhang C, Wu H, Wang R, Ding Q, Hu Y, Xiong Y, Zhang S, Wang L. Immunogenicity and safety of an inactivated enterovirus 71 vaccine co-administered with measles-mumps-rubella vaccine and live-attenuated Japanese encephalitis vaccine: a phase 4, single-center, randomized controlled trial. Hum Vaccin Immunother 2021; 17:5348-5354. [PMID: 34905446 PMCID: PMC8903949 DOI: 10.1080/21645515.2021.2010428] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Co-administration of vaccines could be an efficient strategy to increase vaccination uptake and reduce the number of clinic visits. This randomized controlled study aimed to evaluate the immunogenicity and safety of enterovirus 71 (EV71) vaccine co-administered with measles-mumps-rubella (MMR) vaccine and live-attenuated Japanese encephalitis vaccine (LA-JEV). A total of 372 healthy infants were randomly assigned in a 1:1:1 ratio to receive simultaneous administration of EV71 vaccine (dose 1) and MMR on d 0 and EV71 vaccine (dose 2) and LA-JEV on d 30 (Group 1); administration of MMR and LA-JEV on d 0 and 30, respectively (Group 2); or administration of doses 1 and 2 of EV71 vaccine on d 0 and 30, respectively (Group 3). The non-inferiority analysis of the seroconversion for EV71 neutralizing antibody after vaccination was the primary outcome. According to per protocol set, antibody response against EV71, measles, mumps, rubella, and Japanese encephalitis (JE) virus was similar regardless of administration schedule. After vaccination, the seroconversion rate of EV71 neutralizing antibody in Group 1 (107 [97.27%] of 110) was non-inferior to that in Group 3 (109 [97.32%] of 112; difference - 0.05% [95% CI - 5.38 to 5.21]). The incidences of adverse reactions were 62.60% (77/123) in Group 1, 54.84% (68/124) in Group 2, and 37.70% (46/122) in Group 3, and most of them were mild to moderate in severity. No vaccine-related serious adverse events were reported. In total, the co-administration of combined EV71 vaccine with MMR and LA-JEV showed no interference with antibody response and demonstrated good safety profiles.
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Affiliation(s)
- Xiaoyu Liu
- Center for Clinical Evaluation of Vaccines, Shaanxi Provincial Center for Disease Control and Prevention, Xi’an, China,Lin Wang Sinovac Biotech Co. Ltd, Beijing 100089, China
| | - Wanqi Yang
- Sinovac Biotech Co. Ltd, Beijing, China,Lin Wang Sinovac Biotech Co. Ltd, Beijing 100089, China
| | - Chao Zhang
- Center for Clinical Evaluation of Vaccines, Shaanxi Provincial Center for Disease Control and Prevention, Xi’an, China,Lin Wang Sinovac Biotech Co. Ltd, Beijing 100089, China
| | - Heng Wu
- Department of Immunology, Hanbin District Center for Disease Control and Prevention, Ankang, China,Lin Wang Sinovac Biotech Co. Ltd, Beijing 100089, China
| | - Ruize Wang
- Center for Clinical Evaluation of Vaccines, Shaanxi Provincial Center for Disease Control and Prevention, Xi’an, China
| | - Qiang Ding
- Department of Immunology, Hanbin District Center for Disease Control and Prevention, Ankang, China
| | - Yan Hu
- Department of Immunology, Hanbin District Center for Disease Control and Prevention, Ankang, China
| | | | - Shaobai Zhang
- Center for Clinical Evaluation of Vaccines, Shaanxi Provincial Center for Disease Control and Prevention, Xi’an, China,CONTACT Shaobai Zhang Shaanxi Provincial Center for Disease Control and Prevention, Xi’an710054, China
| | - Lin Wang
- Sinovac Biotech Co. Ltd, Beijing, China,Lin Wang Sinovac Biotech Co. Ltd, Beijing 100089, China
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Li J, Yin X, Lin A, Nie X, Liu L, Liu S, Li N, Wang P, Song S, Wang S, Xu D. EV71 vaccination impact on the incidence of encephalitis in patients with hand, foot and mouth disease. Hum Vaccin Immunother 2021; 17:2097-2100. [PMID: 33522390 DOI: 10.1080/21645515.2020.1851129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
Abstract
In order to analyze the effect of EV71 vaccination on the incidence of encephalitis in patients with HFMD, 292 cases were vaccinated, and 2,486 cases were not vaccinated which were collected in 2018 and 2019. It shows that the incidence rate of encephalitis in vaccinated patients was significantly lower than that in non-vaccinated (P = .028), which suggests that EV71 vaccine has a protective effect on the occurrence of encephalitis. But some EV71 vaccinated patients still developed into encephalitis showed that they had not produced protection or protection was weak against EV71-related encephalitis; the reasons require further investigation.
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Affiliation(s)
- Jian Li
- Infectious Diseases Department, Shandong University Qilu Children's Hospital, Jinan, China
| | - Xiuzhi Yin
- Infectious Diseases Department, Shandong University Qilu Children's Hospital, Jinan, China
| | - Aiwei Lin
- Infectious Diseases Department, Shandong University Qilu Children's Hospital, Jinan, China
| | - Xiuzhen Nie
- Infectious Diseases Department, Shandong University Qilu Children's Hospital, Jinan, China
| | - Liyan Liu
- Infectious Diseases Department, Shandong University Qilu Children's Hospital, Jinan, China
| | - Shihua Liu
- Infectious Diseases Department, Shandong University Qilu Children's Hospital, Jinan, China
| | - Na Li
- Infectious Diseases Department, Shandong University Qilu Children's Hospital, Jinan, China
| | - Ping Wang
- Infectious Diseases Department, Shandong University Qilu Children's Hospital, Jinan, China
| | - Shuangshuang Song
- Infectious Diseases Department, Shandong University Qilu Children's Hospital, Jinan, China
| | - Shaoning Wang
- Infectious Diseases Department, Shandong University Qilu Children's Hospital, Jinan, China
| | - Daoyan Xu
- Infectious Diseases Department, Shandong University Qilu Children's Hospital, Jinan, China
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Zhang Z, Liang Z, Zeng J, Zhang J, He P, Su J, Zeng Y, Fan R, Zhao D, Ma W, Zeng G, Zhang Q, Zheng H. Immunogenicity and Safety of an Inactivated Enterovirus 71 Vaccine Administered Simultaneously With Hepatitis B Vaccine and Group A Meningococcal Polysaccharide Vaccine: A Phase 4, Open-Label, Single-Center, Randomized, Noninferiority Trial. J Infect Dis 2020; 220:392-399. [PMID: 30891604 DOI: 10.1093/infdis/jiz129] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2019] [Accepted: 03/19/2019] [Indexed: 01/16/2023] Open
Abstract
BACKGROUND This study tested the hypothesis that the immunogenicity and safety of the simultaneous administration of enterovirus 71 (EV71) vaccine (dose 1) with recombinant hepatitis B vaccine (HepB) on day 1 and EV71 vaccine (dose 2) with group A meningococcal polysaccharide vaccine (MenA) on day 30 is not inferior to separate administration of each vaccine. METHODS The study was designed as a randomized, open-label, noninferiority trial. A total of 775 healthy infants aged 6 months were randomly assigned in a ratio of 1:1:1 to receive simultaneous administration of EV71 vaccine (dose 1) and HepB on day 1 and EV71 vaccine (dose 2) and MenA on day 30 (the SI group); administration of doses 1 and 2 of EV71 vaccine on days 1 and 30, respectively (the SE1 group); or administration of HepB and MenA on days 1 and 30, respectively (the SE2 group). RESULTS According to the per protocol set, antibody responses against EV71, hepatitis B virus (HBV), and group A meningococcal polysaccharide were similar regardless of administration schedule. With the non-inferiority margin setting at 10%, the seroconversion rates of the three pathogens in the SI group (100% [98.25, 100], 44.84% [38.20, 51.63] and 27.83% [21.91, 34.38]) were not inferior to those in SE1 or SE2 group (100% [98.31, 100], 44.35% [37.82, 51.02] and 29.17% [23.20, 35.72], respectively). Frequencies of adverse reactions to each vaccination regimen were comparable (60.62% in the SI group vs 52.33% in the SE1 group and 56.98% in the SE2 group; P = .16). CONCLUSIONS Simultaneous administration of combined EV71 vaccine with HepB and MenA has noninferior immunogenicity and safety, compared with separate administration of these vaccines. CLINICAL TRIALS REGISTRATION NCT03274102.
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Affiliation(s)
- Zewu Zhang
- Center for Disease Control and Prevention of Dongguan City, Dongguan
| | | | | | - Jikai Zhang
- Guangdong Province Institute of Biological Products and Materia Medica
| | - Peng He
- National Institutes for Food and Drug Control
| | - Jiali Su
- Guangdong Province Institute of Biological Products and Materia Medica
| | - Yaoming Zeng
- Center for Disease Control and Prevention of Dongguan City, Dongguan
| | - Renfeng Fan
- Guangdong Province Institute of Biological Products and Materia Medica
| | - Dan Zhao
- National Institutes for Food and Drug Control
| | - Wenjun Ma
- Guangdong Provincial Institute of Public Health
| | | | - Qiaoli Zhang
- Center for Disease Control and Prevention of Dongguan City, Dongguan
| | - Huizhen Zheng
- Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, China
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Xu Q, Cao Q, Yang W, Liu X, Liu H, Tian X, Li J, Fang X, Jia N, Zeng G, Xu A. Interchangeability of two Enterovirus 71 inactivated vaccines in Chinese children: A phase IV, open-label, and randomized controlled trial. Vaccine 2020; 38:2671-2677. [PMID: 32067817 DOI: 10.1016/j.vaccine.2020.02.013] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2019] [Revised: 01/11/2020] [Accepted: 02/05/2020] [Indexed: 12/29/2022]
Abstract
BACKGROUND In China, three inactivated Enterovirus 71 (EV71) vaccines have been approved. Although the vaccines in an immunization series should be from a single manufacture, children sometimes have to receive EV71 vaccines from more than one manufacturers. The aim of this study was to evaluate the interchangeability and safety of vaccination with EV71 vaccines from two manufacturers among Chinese children. METHODS We conducted an open label and randomized controlled study among children aged 6-35 months from November 2018 to January 2019. The participants were randomly assigned (1:1:1:1) to receive EV71 vaccines in one of the four different schedules (two using a single vaccine for all doses from one manufacture, and two mixed schedules using vaccines from two manufactures). Blood samples were collected pre-vaccination (Day 0) and one month after the second dose (Day 60) for neutralizing antibody assay. Immunogenicity was assessed in the per-protocol cohort and safety was assessed in the total vaccinated cohort. RESULTS A total of 300 children were enrolled and randomized, of whom 89.0% (267/300) were included in the per-protocol cohort for immunogenicity analysis. The seroconversion rates of the EV71 neutralizing antibody in four groups ranged from 98.4% to 100.0%, and were not significantly different among the groups. Compared with other groups, geometric mean titer was higher in group D, in which the participants received Institute of Medical Biology Chinese Academy of Medical Sciences (CAMS) vaccine in the first dose and the Sinovac vaccine in the second dose. Safety profiles were similar among the four groups and no serious adverse events related to the vaccination were reported. CONCLUSIONS Interchangeability of EV71 vaccines from two manufactures to complete an immunization series showed good immunogenicity and safety. The antibody response levels may vary by vaccination sequences of EV71 vaccines from the two manufacturers. TRIAL REGISTRATION ClinicalTrials.govNCT03873740.
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Affiliation(s)
- Qing Xu
- Shandong Provincial Key Laboratory of Infectious Disease Control and Prevention, Shandong Center for Disease Control and Prevention, Jinan, China; Academy of Preventive Medicine, Shandong University, Jinan, China
| | - Qingfan Cao
- Rushan City Center for Disease Control and Prevention, Rushan, Shandong, China
| | - Wanqi Yang
- Sinovac Biotech Co., Ltd., Beijing, China
| | - Xiaodong Liu
- Shandong Provincial Key Laboratory of Infectious Disease Control and Prevention, Shandong Center for Disease Control and Prevention, Jinan, China
| | - Haidong Liu
- Rushan City Center for Disease Control and Prevention, Rushan, Shandong, China
| | | | - Jing Li
- Sinovac Biotech Co., Ltd., Beijing, China
| | - Xueqiang Fang
- Shandong Provincial Key Laboratory of Infectious Disease Control and Prevention, Shandong Center for Disease Control and Prevention, Jinan, China
| | | | - Gang Zeng
- Sinovac Biotech Co., Ltd., Beijing, China.
| | - Aiqaing Xu
- Shandong Provincial Key Laboratory of Infectious Disease Control and Prevention, Shandong Center for Disease Control and Prevention, Jinan, China; Academy of Preventive Medicine, Shandong University, Jinan, China.
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Wang S, Zeng J, Zhang X, Gan Z, Fan J, Chen Y, Liang Z, Hu X, Zeng G, Lv H. Short-term dynamic changes in neutralizing antibodies against enterovirus 71 after vaccination. Hum Vaccin Immunother 2020; 16:1595-1601. [PMID: 31977278 DOI: 10.1080/21645515.2020.1711678] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Short-term dynamic changes in neutralizing antibodies against EV71 and EV71-IgM after inactivated EV71 vaccine injection are unknown. METHODS This study was designed as a randomized, open-label study and was registered at ClinicalTrials.gov (NCT03278132). In total, 120 healthy infants aged 6-35 months were randomized 1:1:1 to provide a second blood sample on day 10, day 20, or day 30 after the first vaccine dose, respectively. RESULTS According to the per-protocol set, a rapid immune response against EV71 was observed 10 days after the first EV71 vaccine dose, with antibody titers ≥1:8 in 89.19% of participants (95% CI: 74.58-96.97%) on day 10, in 80.65% (95% CI: 62.53-92.55%) on day 20, in 66.67% (95% CI: 49.03-81.44%) on day 30, and in 100% (95% CI: 96.52%-.) on day 60. Based on an ELISA, the percentages of participants positive for EV71-IgM on day 0 and day 60 were 1.71% (2 out of 117) and 82.86% (87 out of 105), respectively. CONCLUSIONS The EV71 vaccine could be used for contingency vaccination to further control EV71-associated disease outbreaks. Caution should be taken in using the EV71-IgM test for rapid EV71 infection diagnosis after EV71 vaccine administration. CLINICAL TRIAL REGISTRATION ClinicalTrials.gov NCT03278132.
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Affiliation(s)
- Shenyu Wang
- Department of Immunization Programme, Zhejiang Provincial Center for Disease Control and Prevention , Hangzhou, China
| | - Ji Zeng
- Clinical Research Department, Sinovac Biotech Co., Ltd , Beijing, China
| | - Xinpei Zhang
- Shangyu District Center for Disease Control and Prevention , Shaoxing, China
| | - Zhengkai Gan
- Department of Immunization Programme, Zhejiang Provincial Center for Disease Control and Prevention , Hangzhou, China.,Department of Immunization Programme, Xiuzhou District Center for Disease Control and Prevention , Jiaxing, China
| | - Jianqiang Fan
- Shangyu District Center for Disease Control and Prevention , Shaoxing, China
| | - Yingping Chen
- Department of Immunization Programme, Zhejiang Provincial Center for Disease Control and Prevention , Hangzhou, China
| | - Zhenzhen Liang
- Department of Immunization Programme, Zhejiang Provincial Center for Disease Control and Prevention , Hangzhou, China
| | - Xiaosong Hu
- Department of Immunization Programme, Zhejiang Provincial Center for Disease Control and Prevention , Hangzhou, China
| | - Gang Zeng
- Clinical Research Department, Sinovac Biotech Co., Ltd , Beijing, China
| | - Huakun Lv
- Department of Immunization Programme, Zhejiang Provincial Center for Disease Control and Prevention , Hangzhou, China
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Abstract
Although outbreaks of Hand, Foot, and Mouth Disease (HFMD) in young children have long been recognized worldwide, the occurrence of rare and life-threatening neurological, respiratory, and cardiac complications has propelled this common condition into the spotlight as a major public health problem in the affected countries. Various enteroviruses cause HFMD, but the severe complications have been mostly associated with enterovirus 71 (EV71). Medical treatment is supportive and measures to interrupt transmission have been challenging to implement. Preventive vaccines could have an important clinical impact, especially among children younger than 3 years old who are most susceptible to the neurological complications. Several groups in the highly affected Asia-Pacific region are working towards vaccines against EV71 and some candidates have progressed to late-stage clinical trials with two vaccines recently reported to have been approved by the regulatory authorities in China. This report summarizes current issues and progress in the development of vaccines against EV71.
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Affiliation(s)
- Zarifah Reed
- Clinical Development Consultant, 26 Rue Lecourbe, Paris 75015, France.
| | - Mary Jane Cardosa
- Sentinext Therapeutics, 19H Level 19, Menara Northam, 55, Jalan Sultan Ahmad Shah, 10050 George Town, Pulau Pinang, Malaysia
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