title: Challenges to licensure of enterovirus 71 vaccines.
abstract: Human enteroviruses usually cause self-limited infections except polioviruses and enterovirus 71 (EV71), which frequently involve neurological complications. EV71 vaccines are being evaluated in humans. However, several challenges to licensure of EV71 vaccines need to be addressed. Firstly, EV71 and coxsackievirus A (CA) are frequently found to co-circulate and cause hand-foot-mouth disease (HFMD). A polyvalent vaccine that can provide protection against EV71 and prevalent CA are desirable. Secondly, infants are the target population of HFMD vaccines and it would need multi-national efficacy trials to prove clinical protection and speed up the licensure and usage of HFMD vaccines in children. An international network for enterovirus surveillance and clinical trials is urgently needed. Thirdly, EV71 is found to evolve quickly in the past 15 years. Prospective cohort studies are warranted to clarify clinical and epidemiological significances of the antigenic and genetic variations between different EV71 genogroups, which is critical for vaccine design.
authors.affiliation: National Institute of Infectious Diseases and Vaccinology, National Health Research Institutes, Taiwan.
authors.forename: Min-Shi
authors.initials: MS
authors.lastname: Lee
authors.forename: Fan-Chen
authors.initials: FC
authors.lastname: Tseng
authors.forename: Jen-Ren
authors.initials: JR
authors.lastname: Wang
authors.forename: Chia-Yu
authors.initials: CY
authors.lastname: Chi
authors.forename: Pele
authors.initials: P
authors.lastname: Chong
authors.forename: Ih-Jen
authors.initials: IJ
authors.lastname: Su
mesh_terms: D003384:Coxsackievirus Infections / Q000276:immunology / Q000517:prevention & control* / Q000821:virology; D017277:Drug Approval; D004770:Enterovirus / Q000276:immunology*; D029821:Enterovirus A, Human / Q000276:immunology*; D004769:Enterovirus Infections / Q000276:immunology / Q000517:prevention & control* / Q000821:virology; D006801:Humans; D014765:Viral Vaccines / Q000008:administration & dosage* / Q000009:adverse effects* / Q000276:immunology
chemical_list: D014765:Viral Vaccines