title: Is a multivalent hand, foot, and mouth disease vaccine feasible?
abstract: Enterovirus A infections are the primary cause of hand, foot and mouth disease (HFMD) in infants and young children. Although enterovirus 71 (EV-A71) and coxsackievirus A16 (CV-A16) are the predominant causes of HFMD epidemics worldwide, EV-A71 has emerged as a major neurovirulent virus responsible for severe neurological complications and fatal outcomes. HFMD is a serious health threat and economic burden across the Asia-Pacific region. Inactivated EV-A71 vaccines have elicited protection against EV-A71 but not against CV-A16 infections in large efficacy trials. The current development of a bivalent inactivated EV-A71/CV-A16 vaccine is the next step toward that of multivalent HFMD vaccines. These vaccines should ultimately include other prevalent pathogenic coxsackieviruses A (CV-A6 and CV-A10), coxsackieviruses B (B3 and B5) and echovirus 30 that often co-circulate during HFMD epidemics and can cause severe HFMD, aseptic meningitis and acute viral myocarditis. The prospect and challenges for the development of such multivalent vaccines are discussed.
authors.affiliation: a VaxioBio Inc. ; Toronto, Ontario , Canada.
authors.forename: Michel
authors.initials: M
authors.lastname: Klein
authors.affiliation: b Vaccine R&D Center; National Health Research Institutes ; Zhunan Town, Miaoli County , Taiwan.|c Graduate Institute of Immunology; China Medical University ; Taichung , Taiwan.
authors.forename: Pele
authors.initials: P
authors.lastname: Chong
mesh_terms: D000818:Animals; D055808:Drug Discovery / Q000379:methods / Q000639:trends; D004770:Enterovirus / Q000276:immunology*; D029821:Enterovirus A, Human / Q000276:immunology*; D006232:Hand, Foot and Mouth Disease / Q000276:immunology / Q000517:prevention & control*; D006801:Humans; D007114:Immunization / Q000379:methods*; D014765:Viral Vaccines / Q000008:administration & dosage* / Q000276:immunology*
chemical_list: D014765:Viral Vaccines
keywords: EV-A71 vaccine; bivalent and multivalent vaccines; coxsackievirus A16; coxsackieviruses B3 and B5; echovirus 30; enterovirus A (EV-A); enterovirus A71; epidemiology; foot and mouth diseases; hand; inactivated whole virion vaccines; monovalent