What is hand-foot-mouth disease?

Hand-foot-mouth disease is a contagious disease that is caused by viruses that belong to the Enterovirus family. Common species are Enterovirus 71 (EV71) and Coxsackie virus A16. It usually affects infants and children under 5 years old, occasionally adults will also get the disease. Hand, food, and mouth disease spreads through close personal contact, such as kissing or hugging, coughing and sneezing, contact with feces (poop), and touching objects or surfaces that have the virus on them then putting the fingers in the eyes, nose or mouth.
 

Why should get Entrovac?

Symptoms of hand-foot-mouth disease can take 3 to 7 days to appear. Including fever, loss of appetite, sore throat, generally feeling unwell, painful blister-like sores in the mouth, and a rash with or without small blisters, usually on the palms of the hands or on fingers, soles of the feet or on the toes and may also appear on the knees, elbows, buttocks or genital area. It is usually mild and most people recover in 7 to 10 days. Serious complications from this disease are rare. EV71 is more likely to cause problems. The complications may include encephalitis, meningitis, myocarditis, heart Failure and pulmonary edema, which may lead to death.

Enterovirus Type 71 vaccine can induce immunity against EV71 to prevent hand-foot-mouth disease caused by infection of EV71. The vaccine cannot be used for prevention of hand-foot-mouth disease caused by other enteroviruses (including Coxsackievirus A16 and etc.). From the clinical study, the vaccine efficacy against EV 71 associated Hand-Foot-Mouth disease was 97.3%.
 

Who should get Entrovac and when?

This vaccine suits for EV71 susceptible aged from 6 months to 5 years old. Administer by intramuscular injection (recommended position is the upper arm) 0.5 milliliters each dose for 2 doses, at an interval of one month as below;

 

Enterovirus type 71 vaccine	1st dose	2nd dose
Schedule	Age from 6 months to 5 years old	1 month after the first dose

 

What should be done if Entrovac vaccine series was not completed?

Contact your doctor if a dose is missed. You may not be fully protected against disease if you do not receive the full series. If you miss a dose or get behind schedule, get the next dose as soon as you can.

 

Who should not get Entrovac or should wait?

• A person who has allergic to active and any non-active components used in the preparation, including excipients, formaldehyde and kanamycin sulfate.
• People who suffer from fever or in the period of acute disease.
• People who suffer from serious chronic disease or with allergic constitution.

 

What are the possible undesirable effects from Entrovac?

With any medicine, including vaccines, there is a chance of side effects. These are usually mild and go away on their own. Serious reactions are also possible but are rare. Most people who get Enterovirus Type 71 vaccine do not have any problems with it.

 

Very common (greater than or equal to 10%)	fever
Common (greater than or equal to 1% to 10%)	pain, erythema, swell, induration at injection site decreased appetite, irritability, diarrhea, nausea, vomiting,  fatigue, hypersensitivity
Uncommon (greater than or equal to 0.1% to 1%)	pruritus (local reaction)

 

**If a severe allergic reaction occurs, please consult the doctor**
 

What to do if the child has discomfort?

• If there is a fever, take a fever-reducing medicine such as paracetamol by appropriate dose.
• If there is an injection site pain, swollen, hot, or red, apply a clean, cool, wet washcloth over the sore area.

 

Drug interaction between Entrovac and other medications

• At present, there is no data to evaluate the interaction about the interaction of Enterovirus Type 71 vaccine concomitant administrated with other vaccines.
• Some medicines may interact with this vaccine. Inform the healthcare provider if you are taking any other medicines, especially of immunosuppressive drugs. They may reduce the immune response to vaccines.
• The interval should be at least 1 month between vaccinating this vaccine and injecting immunoglobulin, less affecting the immune effect.

 

References

• EntroVac [package insert]. Bangkok: Biovalys Co.Ltd.; 2022.
• Centers for Disease Control and Prevention. Hand, Foot, and Mouth Disease (HFMD). Available from: https://www.cdc.gov/hand-foot-mouth/index.html [Accessed 13 September 2022].
• Pediatric Infectious Disease Society of Thailand. Hand, Foot, and Mouth Disease. Available from: https://www.pidst.or.th/A705.html [Accessed 13 September 2022].
• Li R, Liu L, Mo Z, Wang X, Xia J, Liang Z, et al. An inactivated enterovirus 71 vaccine in healthy children. N Engl J Med. 2014 Feb 27;370(9):829-37. doi: 10.1056/NEJMoa1303224. PMID: 24571755.