河南省某县肠道病毒EV71疫苗接种意愿及影响因素

目的 调查散居和托幼儿童家长肠道病毒EV71疫苗接种意愿、影响因素和不愿接种的原因,为制定疫苗接种策略提供科学依据.方法 2017年选取河南省某县某幼儿园儿童家长及散居儿童家长作为调查对象,自行设计问卷,集中填写并回收,分析EV71疫苗接种意愿及其影响因素.结果 共发放调查问卷362份,回收351份,279人(79.5...     

某区5岁及以下儿童家长手足口病认知和EV71疫苗接种意愿调查

目的 了解某区5岁及以下儿童家长对手足口病的认知情况和EV71疫苗接种意愿,为制定EV71疫苗免疫策略和健康促进提供科学依据。方法 采用整群随机抽样从北京市某区44家社区卫生服务中心抽取6家,对6家社区卫生服务中心接种门诊接种日当天带领儿童来进行预防接种的5岁及以下儿童家长进行面访并填写调查问卷。结果 该区5岁及以下儿童家长对手足口病防治知识知晓率为71%(95%CI=66%~76%),对预防措施的认知好于对传播途径的认知。儿童母亲(OR=2.77,95%CI=1.67~4.57)、本科/大专以上学历的儿童家长(OR=2.10,95% CI =1.24~3.56)、高年龄儿童的家长(OR=1.58,95%CI=1.10~2.26)知晓率更高。75%的被调查儿童家长表示会为孩子接种EV71疫苗,其中58%的家长更希望能够以“一类疫苗”和28%认为“一类疫苗或二类疫苗都行”的形式提供接种服务;知道我国正在研制EV71疫苗的家长接种意愿高于不知道者(OR=2.57,95%CI=1.17~5.65);25%的被调查儿童家长不会给孩子接种EV71疫苗,“担心疫苗不安全”(67%)和“担心疫苗效果不好”(34%)是最主要原因。结论 对低年龄儿童的家长、低学历家长更应加强手足口病知识宣传,以提高手足口病知识知晓程度。建议优先考虑将EV71疫苗作为一类疫苗进行接种,并通过多种途径向公众报告疫苗研究进展和EV71疫苗宣传,尤其提供预防接种服务的医务人员应积极向儿童家长宣传接种EV71疫苗,以提高儿童家长接种意愿。     

南京市儿童家长手足口病认知和EV71疫苗接种意愿调查

目的 了解南京市5岁以下儿童家长对手足口病和EV71疫苗的认知,分析其影响因素,为EV71疫苗的市场应用提供基础数据。方法 采用多阶段抽样方法在南京市抽取300名儿童家长进行问卷调查,采用logistic回归分析手足口病认知的影响因素。结果 本研究调查300人,手足口病知识回答正确率为45.52%。高学历（OR=2.181,95%CI=1.344~3.538）、儿童年龄较大（OR=1.884,95%CI=1.171~3.030）是家长知识知晓的促进因素。300人中有25人知道已有上市 EV71疫苗可以预防手足口病,电视、网络、社区宣传是前三大获知途径。300人中有 162（54.00%）人愿意接种 EV71疫苗。结论 应针对健康宣教薄弱环节,加大对低学历家长、低年龄儿童家长的宣传力度,并帮助居民树立对疫苗安全性的信心,以提升居民对手足口病的认知和EV71疫苗的接种意愿。     

天津市滨海新区托幼儿童家长对手足口病认知及EV71疫苗接种意愿调查分析

目的 2016年天津市滨海新区开始推广使用手足口病(hand,foot and mouth disease,HFMD)肠道病毒71型(Enterovirus 71,EV71)灭活疫苗。本研究旨在了解天津市滨海新区托幼儿童家长对EV71疫苗的认知情况,分析影响因素,为科学开展疫苗接种预防HFMD提供依据。方法 2018-10-22-2018-11-08随机抽取滨海新区4个幼儿园,发放自制手足口病认知情况及EV71疫苗接种意愿调查表,收集儿童家长信息。采用单因素χ~2检验对儿童家长EV71疫苗的认知及影响因素进行分析。结果本调查滨海新区托幼儿童家长的HFMD防治知识及格率为98.23%(289/310),进行HFMD防治知识影响因素分析,发现幼儿家长教育水平越高(χ~2=28.322,P0.01)、年龄越小(χ~2=9.227,P0.05),HFMD防治知识及格率越高。家长对HFMD EV71疫苗知晓率为33.87%(105/310)。HFMD知识得分(χ~2=5.962,P0.05)和教育水平(χ~2=6.997,P0.05)对HFMD EV71疫苗知晓情况的差异有统计学意义。在调查的家长中,愿意给孩子接种HFMD EV71疫苗的仅占23.59%(67/284),家长不愿接种疫苗或持观望态度的最主要原因是担心疫苗安全性,占85.25%(185/217)。在疫苗价格调查中,64.84%(201/310)家长可以接受疫苗价格,53.87%(167/310)家长同意纳入Ⅰ类疫苗管理。结论天津市滨海新区托幼儿童家长对HFMD相关知识的掌握程度较好,但对EV71及EV71疫苗了解程度较低,疫苗接种意愿较差,需要适当加大相关疾病和疫苗知识的宣传力度。     

EV71疫苗接种意愿与接种行为差异分析

目的 了解肠道病毒71型（EV71）疫苗接种行为及其与接种意愿差异的影响因素,以更好地发挥该疫苗的作用。方法 在广东省广州市海珠区选取5个街道,于2016年6月在各街道接种门诊共选取1 483名6~35月龄儿童家长进行基线调查,其中1 113名于EV71疫苗投入使用约4个月后完成了随访调查,分析疫苗接种及其与接种意愿差异的影响因素。结果 基线调查、随访调查的愿意接种率分别为81.39%、83.47%;1 113名随访调查者EV71疫苗接种率为67.30%,与接种意愿差异有统计学意义（χ²=78.433,P=0.000）。家长认为疫苗安全或不清楚是否安全、认为疫苗可以≥70%或不确定多大概率预防手足口病以及听从接种医生的安排或建议是家长让儿童接种EV71疫苗的有利因素（P＜0.05）;而儿童有手足口病史、较清楚EV71病毒与手足口病关系的家长则倾向于不让儿童接种EV71疫苗（P＜0.05）。对愿意接种者而言,认为疫苗安全或不清楚是否安全（OR_{很安全vs不安全}=5.264,OR_{一般vs不安全}=3.757,OR_{不清楚vs不安全}=1.582）是促使其将意愿转变为实际接种的因素,而认为疫苗价格较贵（OR_贵vs便宜=0.543）、较清楚EV71病毒与手足口病关系（OR_{清楚vs不清楚}=0.544,OR_{部分清楚vs不清楚}=0.731）则是阻碍其将意愿付诸行动的因素;对不愿接种者而言,听从接种医生的安排或建议（OR_{很大程度vs很小程度}=3.074,OR_{一般程度vs很小程度}=1.836）以及受朋友等其他人的影响较大（OR_{很大程度vs很小程度}=2.445）是促使其意愿转变并最终接种疫苗的因素,而清楚EV71病毒与手足口病关系（OR_{清楚vs不清楚}=0.416）则是使其坚持意愿不接种疫苗的因素。结论 家长对EV71疫苗效果、安全性及EV71病毒与手足口病关系的认识以及接种医生的安排或建议是影响EV71疫苗接种的重要因素。     

儿童家长对手足口病及接种EV71疫苗的认知程度调查

目的 通过调查对社区居民在手足口病及EV71疫苗方面的相关知识和态度进行了解,为更好的预防手足口病、进一步顺利开展健康教育工作提供建议.方法 2018年1月—2019年1月在四季青镇社区卫生服务中心接种门诊随机抽取自愿加入的3周岁以下(含3周岁)婴幼儿家长共计700名作为调查对象,以调查问卷的形式了解其对手足口病相关知...     

北京市顺义区5岁以下婴幼儿家长手足口病认知情况与EV71疫苗接种意愿调查

目的 了解北京市顺义区5岁以下婴幼儿家长对手足口病认知情况及EV71疫苗接种意愿,为手足口病防控工作提供科学依据.方法 采用随机抽样对免疫接种门诊的5岁以下婴幼儿家长进行面对面问卷调查,共调查611名婴幼儿家长.结果 调查结果显示,手足口病的传播途径及预防措施知晓率较高,对于少数患者可出现无菌性脑膜炎等重症表现(20.95％)知晓率很低.仅51.06％婴幼儿家长知晓EV71是手足口病的病原体,对于其他病原体知晓率更低.手足口病防治知识知晓率主要受免疫接种门诊级别、户籍类型及文化程度影响.家长对EV71疫苗的认知度不高,但EV71疫苗接种意愿较高,74.14％的家长愿意为孩子接种EV71疫苗,其中74.43％希望作为第一类疫苗由政府免费提供;25.86％的家长不愿意给孩子接种EV71疫苗,不愿接种原因主要为担心疫苗不安全(58.23％).家长是否愿意为孩子接种手足口病疫苗主要受孩子年龄、文化程度及家庭收入影响.结论 今后开展手足口病防治知识健康教育需有针对性;今后应加强EV71疫苗相关知识宣教,加大对疫苗安全性、保护效果的宣传力度.     

洛阳市接种EV71疫苗后手足口病发病观察

目的了解EV71疫苗上市后洛阳市手足口病流行特征,评估EV71疫苗接种效果。方法对临床报告的手足口病人询问并核实疫苗接种信息,对接种疫苗者仍发病者进行流行病学调查。结果 2018年洛阳市共报告手足口病5 926例,接种疫苗后发病510例,占所有病例的8.61%。接种疫苗后发病者的地区、年龄、性别、重症等于总体无统计学差异。疫苗接种后发病的实验室诊断病例64例,其中EV71感染5例,占7.81%;疫苗来源于3个厂家,5例接种后仍感染EV71手足口病患儿临床表现轻微,无重症病例。结论接种EV71疫苗后手足口病流行特征无明显改变,需进一步推广应用,开展效果评价。     

2016年浙江省象山县5岁及以下幼儿家长手足口病认知和EV71疫苗接种意愿调查

目的 了解浙江省象山县5岁及以下幼儿家长对手足口病认知情况和EV71疫苗接种意愿,为手足口病防控工作提供科学依据。 方法 利用随机抽样表从宁波市免疫规划信息管理系统中随机抽取5岁及以下象山在册儿童,对儿童父母进行问卷调查。 结果 调查结果显示,幼儿父母对手足口病认知差异有统计学意义(χ²=13.33,P＜0.01),仅30.51%的家长听说过肠道病毒EV71型,30.85%的家长听说过EV71疫苗,61.02%的家长愿意让自己的子女接种EV71疫苗。不愿意给孩子接受EV71疫苗家长中,59.57%担心疫苗安全性。家长是否愿意给孩子接种手足口病疫苗主要受孩子平时身体状况(OR=0.593)、手足口病患病史(OR=1.913)、家长是否认为手足口病是严重疾病(OR=1.661)、是否担心孩子患手足口病(OR=1.485)、EV71疫苗的安全性(OR=1.600)、EV71疫苗的价格影响(OR=0.321)。 结论 今后应加强手足口病疫苗相关知识的宣教,特别是疫苗安全性、效果等方面的宣传,并开展EV71疫苗相关的持续效果评价和不良反应监测。     

开封市5岁以下儿童家长对手足口病和EV71疫苗认知调查

目的探索开封市5岁以下儿童家长对手足口病和EV71疫苗的认知调查及其影响因素。方法采用多阶段抽样在开封市选取302名儿童家长进行问卷调查,采用Logistic多因素分析手足口病认知的影响因素。结果儿童年龄≥25个月、家长文化程度大专/本科及以上、家庭住址类型城区城乡结合部、有医学人员知晓率较高,数据对比具有统计学意义(P0.05)。多因素结果显示,儿童年龄、家长文化程度是影响儿童家长手足口病和EV71疫苗认知程度的独立危险因素(P0.05)。结论临床上应该加强低年龄儿童家长、低学历家长的健康宣教,并提升居民对EV71疫苗安全性的信心,树立居民对EV71疫苗的接种意愿和增强对手足口病的认知。     

Willingness and influential factors of parents to vaccinate their children with novel inactivated enterovirus 71 vaccines in Guangzhou,China

Hand, foot and mouth disease (HFMD) primarily affects children younger than 5 years of age. Recently, HFMD has ranked as the top notifiable infectious disease in China. In December 2015, China approved two novel inactivated enterovirus 71 vaccines (EV71 vaccines) for HFMD. Parents’ acceptance is often essential for vaccination program success. The goal of this study was to identify willingness and influential factors to vaccinate among parents of kindergarteners in Guangzhou, China. A cross-sectional survey of face-to-face interviews was conducted from March to July 2016. Fifty-five kindergartens were randomly selected from 11 districts of Guangzhou. An anonymous self-designed questionnaire was used to investigate awareness, knowledge and attitude towards HFMD and EV71 vaccines. A total of 868 parents participated in the survey. Mean(±standard deviation) knowledge score of HFMD was 6.32(±1.70). Approximately 32.03% of parents had heard of the EV71 vaccines with 22.58% receiving information before this study. Nearly 44.24% of parents showed willingness to vaccinate their children. Previously receiving EV71 vaccine-related information [adjusted odds ratio (aOR) = 1.48, 95% confidence interval (CI): 1.04–2.11], no fear of adverse effects (aOR = 4.25, 95%CI: 2.77–6.53), perceived susceptibility of children to HFMD (aOR = 2.15, 95%CI: 1.42–3.25) and children not previously diagnosed with HFMD (aOR = 1.56, 95%CI: 1.07–2.27) were positively associated with EV71 vaccination acceptability. However, parental education background (aOR = 0.54, 95%CI: 0.37–0.80) was negatively correlated with vaccination acceptability. Our study provides baseline information for future vaccination campaigns to help improve the EV71 vaccine uptake rate. Special efforts are urgently needed to improve the awareness and knowledge of EV71 vaccines in China.     

杭州市儿童肠道病毒71型灭活疫苗接种特征分析

目的分析杭州市2014-2017年出生儿童肠道病毒71型(EV71)疫苗接种情况,为今后EV71疫苗的接种实施提供依据。方法从杭州市儿童免疫规划信息管理系统中导出2014-2017年出生儿童EV71疫苗接种数据,运用描述流行病学方法进行分析。结果在550888名2014-2017年出生儿童中,第1剂次EV71疫苗接种率为29.15%,2014-2017年各年出生儿童接种率分别为11.55%、22.13%、37.93%和42.16%,城区、城乡结合部、郊县儿童接种率分别为43.85%、20.78%和27.87%。第2剂次接种率为26.59%,2014-2017年各年龄组儿童接种率分别为10.14%、20.03%、35.23%和38.31%,城区、城乡结合部、郊县儿童接种率分别为40.51%、18.59%和24.61%。EV71疫苗主要接种年龄为1岁,其中10~13月龄为接种高峰。结论杭州市EV71疫苗接种率虽逐年上升但有待进一步提高,接种月龄偏晚,需加强EV71疫苗接种宣传,使儿童尽早完成接种获得免疫保护。     

Similar protective immunity induced by an inactivated enterovirus 71 (EV71) vaccine in neonatal rhesus macaques and children

During the development of enterovirus 71 (EV71) inactivated vaccine for preventing human hand, foot and mouth diseases (HFMD) by EV71 infection, an effective animal model is presumed to be significant and necessary. Our previous study demonstrated that the vesicles in oral regions and limbs potentially associated with viremia, which are the typical manifestations of HFMD, and remarkable pathologic changes were identified in various tissues of neonatal rhesus macaque during EV71 infection. Although an immune response in terms of neutralizing antibody and T cell memory was observed in animals infected by the virus or stimulated by viral antigen, whether such a response could be considered as an indicator to justify the immune response in individuals vaccinated or infected in a pandemic needs to be investigated. Here, a comparative analysis of the neutralizing antibody response and IFN-γ-specific T cell response in vaccinated neonatal rhesus macaques and a human clinical trial with an EV71 inactivated vaccine was performed, and the results showed the identical tendency and increased level of neutralizing antibody and the IFN-γ-specific T cell response stimulated by the EV71 antigen peptide. Importantly, the clinical protective efficacy against virus infection by the elicited immune response in the immunized population compared with the placebo control and the up-modulated gene profile associated with immune activation were similar to those in infected macaques. Further safety verification of this vaccine in neonatal rhesus macaques and children confirmed the potential use of the macaque as a reliable model for the evaluation of an EV71 candidate vaccine.     

肠道病毒71型灭活疫苗滴度的酶联免疫吸附检测方法

目的 建立肠道病毒71型(EV71)灭活疫苗滴度的检测方法,用于疫苗研制及生产过程中抗原含量的测定.方法 以兔抗EV71多克隆抗体为包被抗体,小鼠抗EV71单克隆抗体为检测抗体,以夹心ELISA方法测量我们制备的EV71疫苗抗原参照品,建立抗原标准曲线,确定定量限度及最佳定量范围,同时验证该方法的特异性和可重复性.结果...     

Patterns and influencing factors of COVID-19 vaccination willingness among college students in China

BackgroundVaccination is an important preventive measure against the coronavirus disease 19 (COVID-19) pandemic. We aimed to examine the willingness to vaccination and influencing factors among college students in China.MethodsFrom March 18 to April 26, 2021, we conducted a cross-sectional online survey among college students from 30 universities in Wuhan, Hubei Province, China. The survey was composed of the sociodemographic information, psychological status, experience during pandemic, the willingness of vaccination and related information. Students’ attitudes towards vaccination were classified as ‘vaccine acceptance’, ‘vaccine hesitancy’, and ‘vaccine resistance’. Multinomial logistic regression analyses were performed to identify the influencing factors associated with vaccine hesitancy and resistance.ResultsAmong 23,143 students who completed the survey, a total of 22,660 participants were included in the final analysis with an effective rate of 97.9% after excluding invalid questionnaires. A total of 60.6% of participants would be willing to receive COVID-19 vaccine, 33.4% were hesitant to vaccination, and 6.0% were resistant to vaccination. Social media platforms and government agencies were the main sources of information vaccination. Worry about the efficacy and adverse effects of vaccine were the top two common reason of vaccine hesitancy and resistance. Multiple multinomial logistic regression analysis identified that participants who worried about the adverse effects of vaccination were more likely to be vaccine hesitancy (aOR = 2.44, 95% CI = 2.30, 2.58) and resistance (aOR = 2.71, 95% CI = 2.40, 3.05).ConclusionMore than half of college students are willing to receive the COVID-19 vaccine, whereas nearly one-third college students are still hesitant or resistant. It is crucial to provide sufficient and scientific information on the efficacy and safety of vaccine through social media and government agencies platforms to promote vaccine progress against COVID-19 and control the pandemic in China.     

2017-2021年中国肠道病毒71型灭活疫苗接种现状分析

目的了解2017-2021年中国肠道病毒71型(EV71)灭活疫苗接种现状, 为制定手足口病防控和免疫策略提供参考。方法利用中国免疫规划信息管理系统收集的EV71灭活疫苗报告接种剂次数和出生人口数据估算2012年以来各出生队列截至2021年底的全国、分省和分地市EV71灭活疫苗累计接种率, 并分析与接种率水平相关的潜在影响因素。结果截至2021年, 全国2012年以来出生队列EV71灭活疫苗估算累计接种率为24.96%, 各省份估算接种率为3.09%～56.59%, 各地市估算接种率为0～88.17%。不同地区疫苗接种率与该地区既往手足口病报告发病水平和人均可支配收入的相关性均有统计学意义。结论 2017年以来EV71灭活疫苗在全国范围内应用广泛, 但地区间疫苗接种覆盖情况差异较大, 经济相对发达地区接种率较高, 既往疾病流行强度可能对疫苗的接受度和接种服务模式产生一定影响。EV71灭活疫苗接种对手足口病流行的影响还需进一步研究。     

Immunoprotection elicited by an enterovirus type 71 experimental inactivated vaccine in mice and rhesus monkeys

A number of commonly recognized public health issues are associated with EV71 infection, including the induction of severe cases of hand-foot-and-mouth disease (HFMD). Because of such issues, research and development of EV71 vaccine candidates is of growing importance. In the present study, an experimental EV71 inactivated vaccine was prepared, and its corresponding immunogenicity was analyzed. The immune responses and immunoprotective effect induced by the vaccine in mice and rhesus monkeys are described, and the two animal models are compared to evaluate the potential of assessing the inactivated vaccine's immunogenicity in these two species. In addition to assessing the vaccine's efficacy in mice, our data further elucidate the significance and value of assessing the immunogenicity and immunoprotection of vaccine candidates in rhesus monkeys by relying on a range of analyses, including pathological, etiological and lethal challenge analyses.     

浙江省嘉善县儿童监护人肠道病毒71型疫苗接种意愿及影响因素的调查分析

目的 了解嘉善县5岁以下儿童监护人对肠道病毒71型(EV71)疫苗的接种意愿,分析其影响因素,为制定疫苗接种和疫情防控策略提供依据.方法 在嘉善县所有接种门诊接种现场随机选取5岁以下儿童监护人进行统一问卷调查.结果 共调查854名监护人,其中488名监护人(57.14％)愿意为孩子接种EV71疫苗,366名监护人(42.86％)不愿意为孩子接种EV71疫苗;调查儿童中有54名(6.32％)曾患过手足口病.监护人文化程度越高(x2趋势=7.59,P＜0.01)、年收入越高(x2趋势=13.31,P＜0.01)越愿意为孩子接种EV71疫苗.儿童监护人性别为男性(OR=1.38,95％CI:1.04～1.85)、听说过EV71疫苗(OR=1.51,95％CI:1.15～1.99)、孩子曾患过手足口病(OR =4.66,95％CI:2.17～9.99)是愿意为孩子接种EV71疫苗的保护因素.监护人不愿意接种的主要原因为担心疫苗安全性和不良反应(45.63％)、担心疫苗保护效果(26.78％)和疫苗价格太高(17.76％).结论 嘉善县儿童监护人对EV71疫苗的接种意愿不高,今后应加强EV71疫苗和手足口病相关知识的健康教育,提高家长对疾病的认识,消除在疫苗安全性与接种效果等方面的顾虑,提高疫苗接种率.     

2008年湖州市肠道病毒71型和COXA16型的监测分析

目的:了解湖州市肠道病毒的感染情况,为制定预防和控制肠道病毒感染提供依据。方法:采用荧光定量RT-PCR和RT-PCR方法,对湖州市101例疑似肠道病毒感染者的疱疹液、咽拭子及粪便标本进行肠道病毒通用核酸、肠道病毒71型和柯萨奇病毒A16的核酸检测。结果:肠道病毒通用核酸阳性87例,阳性率为86.14%(87/101)。其中EV71阳性20例,阳性率为19.80%(20/101);Cox A16阳性1例,阳性率为0.99%(1/101),二者均阴性14例。男女发病率分别为18.46%(12/65)和25.0%(9/36)。疱疹液中EV71检出率24.32%(9/37),Cox A l6检出率2.70%(1/37);咽拭子中EV71检出率18.96%(11/58),Cox A l6未检出;粪便标本中EV71和Cox A l6均未检出。结论:EV71是引起湖州市儿童手足口病的主要病原体,Ev71和Cox A16的发病率无性别差异,疱疹液、咽拭子标本中EV71及Cox A16的检出率明显高于粪便标本,要加强对Ev71和Cox A16的鉴别诊断,有利于提出更好的预防和控制措施。     

Efficacy of an inactivated bivalent vaccine for enterovirus 71 and coxsackievirus A16 in mice immunized intradermally

Human hand, foot, and mouth disease (HFMD), an important infectious disease in children, is caused mainly by enterovirus 71 (EV71) and coxsackievirus A16 (CA16). In this study, a bivalent inactivated EV71/CA16 vaccine is developed and evaluated in immunized BALB/c mice injected through the intradermal route. Q-RT-PCR detection of the mRNA of immune signal molecules in local epithelial tissues inoculated with the vaccine indicates activation of innate immunity, which includes upregulation of immune-related chemokines, interferons and CD molecules. Further, the finding that neutralizing antibodies and specific T cellular responses were elicited in adult mice after two immunizations with the vaccine at a 28-day interval, which endowed offspring mice to defend a viral challenge, suggests the successful induction of specific protective antiviral immunity. All these data suggest that immunization with this bivalent EV71/CA16 vaccine via the intradermal route elicits effective immunity against EV71 and CA16 infection.