Author Interviews, Cancer Research, Herpes Viruses, Vaccine Studies / 06.08.2014

Sara Tartof, PhD, MPH Post-doctoral research fellow Kaiser Permanente Southern California Department of Research & Evaluation.MedicalResearch.com Interview with: Sara Tartof, PhD, MPH Post-doctoral research fellow Kaiser Permanente Southern California Department of Research & Evaluation. Medical Research: What are the main findings of the study? Dr. Tartof: Our study found that the herpes zoster vaccine continues to be effective in protecting older adults against shingles, even after they undergo chemotherapy. In particular, we found that those patients who were previously vaccinated with the vaccine were 42 percent less likely to develop shingles following chemotherapy treatment. We also found that none of our vaccinated patients underwent hospitalization for shingles, while six unvaccinated patients were hospitalized with the disease.
Author Interviews, Pediatrics, Vaccine Studies / 01.08.2014

Jana Shaw MD, MPH, FAAP Associate Professor of Pediatrics Pediatric Infectious Diseases SUNY Upstate Medical University 750 East Adams Street Syracuse, NY 13210MedicalResearch.com Interview with: Jana Shaw MD, MPH, FAAP Associate Professor of Pediatrics Pediatric Infectious Diseases SUNY Upstate Medical University 750 East Adams Street Syracuse, NY 13210 Medical Research: What are the main findings of the study? Dr. Shaw: In this study, we looked at exemptions to school immunization requirements in the US during 2009-2010 school year. We found that private schools have higher rates for all types of exemptions (medical, religious, and personal belief/philosophical). In addition, states that permitted personal belief exemptions had higher rates of exemptions overall compared to states that did not allow them.
Author Interviews, Clots - Coagulation, JAMA, Vaccine Studies / 09.07.2014

MedicalResearch.com Interview with: Nikolai Madrid Scheller Department of Epidemiology Research Statens Serum Institut, Copenhagen Medical Research: What are the main findings of the study? Answer: In a large and comprehensive study of more than 1.5 million women including more than 500,000 HPV vaccinated there was no association between HPV vaccination and blood clots.
Author Interviews, BMJ, Infections, Pediatrics, Vaccine Studies / 25.06.2014

Kay Wang Academic Clinical Lecturer Nuffield Department of Primary Care Health Sciences University of Oxford, Oxford, UKMedicalResearch.com: Interview with Kay Wang Academic Clinical Lecturer Nuffield Department of Primary Care Health Sciences University of Oxford, Oxford, UK MedicalResearch: What are the main findings of the study? Dr. Wang: We have found evidence of recent whooping cough infection in 1 in 5 school age children who see their doctor with a persistent cough and in 1 in 6 children who have been fully vaccinated against whooping cough.  We have also shown that whooping cough can still cause clinically significant cough in fully vaccinated children.
Annals Internal Medicine, Author Interviews, Hepatitis - Liver Disease, OBGYNE, Vaccine Studies / 29.05.2014

Ai Kubo, MPH PhD Kaiser Permanente Division of Research 2000 Broadway Oakland, CA 94612MedicalResearch.com Interview with: Ai Kubo, MPH PhD Kaiser Permanente Division of Research 2000 Broadway Oakland, CA 94612 MedicalResearch: What are the main findings of the study? Dr. Kubo: The main findings of the study are three folds: 1)  The CDC guideline works for the majority of infants in preventing vertical transmission, if the immunizations are done according to the recommended schedule. 2) It takes an organized effort to case-manage each mother-infant pairs in order to achieve almost complete immunization rates and very low transmission rates. 3) Highest risk group was mothers with extremely high viral load and e-antigen positivity.  This group of women may benefit from additional therapy to prevent the vertical transmission. However, for others, the risk of transmission is extremely low as long as the infants are immunized according to the guideline.
Author Interviews, Cancer Research, JAMA, Vaccine Studies / 27.05.2014

Scott A. Gruber, M.D., Ph.D., MBA, FACS, FCP, FACHE, CPE Chief of Staff, John D. Dingell VA Medical Center Associate Dean for Veterans Affairs & Professor of Surgery Wayne State University School of Medicine John D. Dingell VA Medical Center Chief of Staff Detroit, MI 48201MedicalResearch.com Interview with: Scott A. Gruber, M.D., Ph.D., MBA, FACS, FCP, FACHE, CPE Chief of Staff, John D. Dingell VA Medical Center Associate Dean for Veterans Affairs & Professor of Surgery Wayne State University School of Medicine John D. Dingell VA Medical Center Chief of Staff Detroit, MI 48201 MedicalResearch: What are the main findings of the study? Dr. Gruber: We successfully addressed the problem of inadequate intracellular delivery of tumor- specific antigens (TSAs) to dendritic cells (DCs) by using synthetic cell-penetrating domains or peptides (CPPs) to create fusion tumor antigens (Ags) that readily penetrate through the plasma membrane. We demonstrated cloning and purification of the TSA melanoma-associated antigen 3 (MAGE-A3) in frame with CPP, producing enhanced cytosolic bioavailability in dendritic cells without altering cell functionality. Further, we showed that recombinant bacterial proteins can be easily engineered to purify large amounts of CPP-MAGE-A3. Use of full-length proteins circumvents the need to define HLA class I allele binding before vaccination and increases the number of epitopes recognized by CD8+ cytotoxic T lymphocytes (CTLs) when compared with peptide-pulsed dendritic cells. Finally, the use of proteins rather than plasmids or viral vectors for in vitro dendritic cell vaccine preparation avoids the practical and theoretical safety concerns regarding genomic modification.
Author Interviews, Baylor College of Medicine Houston, JAMA, OBGYNE, Vaccine Studies / 16.05.2014

Flor M. Munoz, MD Department of Pediatrics Department of Molecular Virology and Microbiology Baylor College of Medicine, Houston, Texas MedicalResearch.com Interview with: Flor M. Munoz, MD Department of Pediatrics Department of Molecular Virology and Microbiology Baylor College of Medicine, Houston, Texas MedicalResearch.com: What are the main findings of the study? Dr. Munoz: 1. Tdap vaccine was safe and well tolerated during pregnancy 2. Women who are pregnant have adequate responses to the Tdap vaccine, similar to those of women who are not pregnant. 3. Antibodies to pertussis are efficiently transferred to the fetus through the placenta so that babies of mothers who were vaccinated during pregnancy had significantly higher concentrations of antibody at birth and up to 2 months of age, when compared to infants of mothers who were vaccinated post-partum. 4. Higher antibody concentrations in the first two months of life are likely to provide protection against pertussis during this period of high vulnerability 5. Infants of mothers who were vaccinated during pregnancy had adequate responses to their routine pertussis vaccines at 2, 4, and 6 months of age, and had expected and adequate responses to their 4th dose of vaccine at 1 year of age. The absolute concentration of antibodies to some of the pertussis antigens might be modestly lower after the primary series of vaccines in some infants of mothers who were vaccinated during pregnancy, but this difference does not persist after the 4th dose.
Author Interviews, Flu - Influenza, Vaccine Studies / 10.05.2014

MedicalResearch Interview: Dr Nicoline van der Maas MD Epidemiologist National Institute for Public Health and the Environment Centre for Infectious Disease Control Epidemiology and Surveillance The Netherlands MedicalResearch: What are the main findings of the study? Dr. van der Maas: The main finding, presented at the ESPID, is that we found no difference in growth, development and infection related contact rates with the general practitioner after the first year of life between infants of unvaccinated mothers and infants of mothers, vaccinated with an adjuvanted Influenza A (H1N1) vaccine during the second and third trimester of pregnancy. The offer of a H1N1 vaccination to pregnant women in their second and third trimester did not have a negative impact on infants’ health during the first year of life.
Pediatrics, Vaccine Studies / 09.05.2014

Tessa Schurink-van 't Klooster Epidemioloog Rijksvaccinatieprogramma Epidemiologie en Surveillance RIVM - Centrum Infectieziektebestrijding 3720 BA BilthovenMedicalResearch.com Interview with Tessa Schurink-van 't Klooster Epidemioloog Rijksvaccinatieprogramma Epidemiologie en Surveillance RIVM - Centrum Infectieziektebestrijding 3720 BA Bilthoven MedicalResearch: What are the main findings of the study? Answer: The main finding of this study was that we observed no differences in mortality rate ratios for females compared to males related to the type of last offered vaccination in DTP- and MMR-eligible age groups.
Author Interviews, Infections, Kaiser Permanente, Pediatrics, Vaccine Studies / 11.04.2014

Roger Paul Baxter, MD Co-Director Kaiser Permanente Vaccine Study Center Oakland, CA 94612.MedicalResearch.com Interview with: Roger Paul Baxter, MD Co-Director Kaiser Permanente Vaccine Study Center Oakland, CA 94612. MedicalResearch.com What are the main findings of the study? Dr. Baxter:  Menveo, the currently licensed CRM-conjugate meningococcal vaccine, showed an excellent booster response in adolescents, regardless of which conjugate vaccine they had received previously.  Also, although titers from the priming dose waned, at 3 years there were still protective antibodies in the majority of immunized individuals.  The other US-licensed meningococcal conjugate vaccine, Menactra, uses a different protein conjugate.
Author Interviews, BMJ, HPV, Vaccine Studies / 18.03.2014

MedicalResearch.com Interview with: Dr Rachel J Sacks Jefferiss Wing,  St Mary's Hospital Imperial College Healthcare NHS Trust, London UK MedicalResearch.com: What is the background of this study? Dr. Sacks: 2247 anonymous questionnaires were completed by young women, aged 13-19 years old, attending sexual health services across England, looking at their HPV vaccination outcomes and prevalence of risk factors associated with HPV acquisition and cervical cancer development, and comparing the survey results with national data where available. Known HPV acquisition and cervical cancer development risk factors include cigarette smoking, early age at first intercourse, increasing number of lifetime partners, co-infection with other sexually transmitted infections. MedicalResearch.com: What are the main findings of the study Dr. Sacks:
  •          Young women, aged 13  to 19 years old attending sexual health services across England had higher prevalence of known risk factors associated with HPV acquisition and cervical cancer development, compared with national data.
  •          Survey respondents had lower HPV vaccination offer and lower HPV vaccination completion rates than nationally.
  •          Subgroups within the survey respondents were identified as having a significantly lower offer and significantly lower completion rate of the HPV vaccination. These subgroups included respondents from London, those of non-white ethnicities, 17 to 19 year olds, smokers and those not in education, employment or training (NEETs).
  •          The highest risk individuals, in terms of HPV related risk factors, were the least likely to be offered and additional the least likely to complete the HPV vaccination course.
  •          Currently sexual health services in England are not involved in the delivery of the HPV vaccination programme and this is felt to be a huge missed opportunity for the primary prevention of HPV acquisition and its potential sequelae. Sexual health services should be included as a supplementary HPV vaccination delivery site in order to target these particularly vulnerable young women and to increase the success of the HPV vaccination programme in England.
Author Interviews, BMJ, Cancer Research, HPV, Vaccine Studies / 05.03.2014

MedicalResearch.com Interview with: Dr Julia Brotherton Victorian Cytology Service, Melbourne, Victoria, Australia Dr Elizabeth Crowe The University of Queensland, School of Population Health, Brisbane, Australia NHS Borders, Department of Public Health, Melrose, Scotland, UK Prof. David Whiteman Group Leader / Department Coordinator QIMR Berghofer Medical Research Institute Royal Brisbane Hospital, QLD 4029 MedicalResearch.com: What are the main findings of the study? 1.       We conducted a case-control study in which we retrieved the HPV vaccination histories of young Australian women who were notified to the Pap smear registry with high-grade cervical lesions or with other types of cervical lesions, and compared them with the vaccination histories of women whose Pap smears showed only normal cytology. 2.       We found that women with high grade cervical lesions were significantly less likely than women with normal cytology to have received 3 doses of the quadrivalent HPV vaccine, equivalent to a vaccine effectiveness of 46%. 3.       The vaccine effectiveness among 15-19 year old women was even higher at 57%. We believe this reflects the fact that HPV16 causes an even higher proportion of high grade disease in young women due to its higher oncogenicity and shorter latent period. 4.       The HPV vaccine had 34% effectiveness against other cervical lesions (i.e. those not proven to be high grade lesions on histology). 5.       We also observed that 2 doses of the vaccine were 21% effective in preventing both high grade lesions and other grade lesions.
Author Interviews, Infections, JAMA, Vaccine Studies / 25.02.2014

Signe Sørup, PhD Research Center for Vitamins and Vaccines (CVIVA) Bandim Health Project, Statens Serum Institut Artillerivej 5, DK-2300 Copenhagen S, DenmarkMedicalResearch.com Interview with: Signe Sørup, PhD Research Center for Vitamins and Vaccines (CVIVA) Bandim Health Project, Statens Serum Institut Artillerivej 5, DK-2300 Copenhagen S, Denmark MedicalResearch.com: What are the main findings of the study? Dr. Sørup: We found that admissions with any type of infection was reduced with 14 % for Danish children having the live, attenuated vaccine against measles, mumps, and rubella (MMR) as the most recent vaccine compared with children having the inactivated vaccine against Diphtheria, Tetanus, Pertussis, Polio, and Haemophilus Influenzae type b (DTaP-IPV-Hib) as the most recent vaccine. In Denmark herd immunity against measles, mumps, and rubella is high and only 26 of the more 42,000 admissions was related to measles, mumps, and rubella; so this finding cannot be explained by the specific protection against the targeted diseases. In Denmark MMR vaccination is recommended at 15 months of age, but only 50% of the children in the study had received MMR before 16 months of age. We estimated that one hospital admission between 16 and 24 months of age could be avoided for 201 children vaccinated with MMR before 16 months of age rather than later. These results are based on a retrospective cohort study including approximately half a million Danish children. The analyses are adjusted for age and a long range of background factors, including socio-economic factors.
Author Interviews, HPV, JAMA, Karolinski Institute, Vaccine Studies / 12.02.2014

Lisen Arnheim Dahlström Associate Professor (Docent) Institutionen för medicinsk epidemiologi och biostatistik Department of Medical Epidemiology and Biostatistics Karolinska Institutet SwedenMedicalResearch.com Interview with: Lisen Arnheim Dahlström Associate Professor (Docent) Institutionen för medicinsk epidemiologi och biostatistik Department of Medical Epidemiology and Biostatistics Karolinska Institutet Sweden MedicalResearch.com: What are the main findings of the study? Answer: The main finding, when studying HPV vaccine effectiveness against condyloma by dose level is that 3 doses offered the maximum protection, although 2 doses also offered a substantial protection.
Author Interviews, Critical Care - Intensive Care - ICUs, Duke, Flu - Influenza, Vaccine Studies / 11.02.2014

Dr Cameron Wolfe MBBS(Hons), MPH Assistant Professor of Medicine Clinical / Transplant Infectious Diseases Duke University Medical CenterMedicalResearch.com Interview with: Dr Cameron Wolfe MBBS(Hons), MPH Assistant Professor of Medicine Clinical / Transplant Infectious Diseases Duke University Medical Center MedicalResearch.com: What are the main findings of the study? Dr. Wolfe: The major findings of the study were that at least in our center, there was a significant burden of critical illness due to H1N1 influenza infection.  The average age of the patients admitted to the hospital was just 28yrs, consistent with the younger patient age in 2009 when H1N1 emerged.  Most critically, we also observed a significantly lower rate of influenza vaccine uptake in patients admitted to the Intensive Care Units at our center.
Author Interviews, Gastrointestinal Disease, NEJM, Pediatrics, Vaccine Studies / 15.01.2014

W. Katherine Yih Ph.D., M.P.H Department of Population Medicine Harvard Medical School and Harvard Pilgrim Health Care InstituteMedicalResearch.com Interview with: W. Katherine Yih Ph.D., M.P.H Department of Population Medicine Harvard Medical School and Harvard Pilgrim Health Care Institute MedicalResearch.com:  What are the main findings of the study? Dr. Yih: The main findings are that vaccination with the first dose of RotaTeq is associated with a small increase in the risk of intussusception, which is concentrated in the first week after vaccination.  The estimated risk is about 1.5 excess cases per 100,000 first doses administered.  This risk is fairly small, amounting to roughly 1/10 of the risk seen after the original rotavirus vaccine (called Rotashield) that was used in 1998-1999, before it was withdrawn from the market. We also found evidence that Rotarix increases the risk of intussusception.  However, the number of infants receiving Rotarix and the number getting intussusception after Rotarix were too small to allow us to estimate the risk after Rotarix with any precision.
Author Interviews, Gastrointestinal Disease, Infections, NEJM, Vaccine Studies / 15.01.2014

MedicalResearch.com Interview with Eric S. Weintraub, M.P.H. Epidemiologist at Centers for Disease Control and Prevention MedicalResearch.com: What are the main findings of the study? Mr. Weintraub: While current rotavirus vaccines were not associated with intussusception in large pre-licensure trials, recent post-licensure data (from international settings) suggest the possibility of a low risk of intussusception occurrence after receipt of monovalent rotavirus vaccination (RV1).  We examined the risk of intussusception following RV1 vaccination in a U.S. population.  In this study of more than 200,000 doses of RV1, a slight increased risk of intussusception was observed after vaccination, which should be considered in light of the benefits of preventing rotavirus associated illness.
Author Interviews, Flu - Influenza, NEJM, Pediatrics, Vaccine Studies / 15.12.2013

Ghassan Dbaibo, M.D., FAAP Professor and Vice-Chair for Research and Faculty Development Department of Pediatrics and Adolescent Medicine Head, Division of Pediatric Infectious Diseases Director, Center for Infectious Diseases Research Professor, Department of Biochemistry and Molecular Genetics American University of Beirut Beirut, LebanonMedicalResearch.com Interview with: Ghassan Dbaibo, M.D., FAAP Professor and Vice-Chair for Research and Faculty Development Department of Pediatrics and Adolescent Medicine Head, Division of Pediatric Infectious Diseases Director, Center for Infectious Diseases Research Professor, Department of Biochemistry and Molecular Genetics American University of Beirut Beirut, Lebanon MedicalResearch.com: What are the main findings of the study? Dr. Dbaibo:
  • 55% efficacy (95% CI 39–67%) for prevention of all influenza
  • These results are comparable with other estimates of efficacy and effectiveness for trivalent inactivated flu vaccines in this age group
  •  73% efficacy (97.5% CI 47–86%) for prevention of moderate-to-severe influenza
  • By preventing moderate-to-severe influenza, vaccination prevented the most clinically consequential outcomes of infection, reducing hospitalisations by 75% and medical visits by 69%.
  • Seroprotection rates of more than 95% for each of the four influenza strains in the vaccine
  • An acceptable safety and reactogenicity profile
Author Interviews, Lancet, Vaccine Studies / 01.11.2013

Dr Belén Pedrique Epidemiologist Drugs for Neglected Diseases initiative DNDi, 15 Chemin Louis Dunant 1202 Geneva, Switzerland MedicalResearch.com Interview with : Dr Belén Pedrique Epidemiologist Drugs for Neglected Diseases initiative DNDi, 15 Chemin Louis Dunant 1202 Geneva, Switzerland MedicalResearch.com : What are the main findings of the study? Dr. Pedrique: Of the 850 new drugs and vaccines approved for all diseases in 2000-2011, 4% (37) were for neglected diseases, defined broadly as those prevalent primarily in poor countries: malaria, tuberculosis, 17 neglected tropical diseases (NTDs) as defined by the World Health Organization (WHO), 11 diarrheal diseases, and 19 other diseases of poverty, excluding HIV/AIDS. Globally these neglected diseases represent an 11% health burden, based on a recent assessment of 2010 disability-adjusted life-years (DALYs). Most newly developed therapeutic products were repurposed versions of existing drugs. Of the 336 brand-new drugs (new chemical entities, or NCEs) approved for all diseases in 2000-2011, only four, or 1%, were for neglected diseases; three were for malaria, and one for diarrheal disease. None were for any of the 17 WHO-listed NTDs Of 148,445 phase I-III clinical trials registered as of Dec 31, 2011, only 1% (2,016) were for neglected diseases.
Author Interviews, Flu - Influenza, Pediatrics, Vaccine Studies / 29.10.2013

MedicalResearch.com Interview with: Karen K. Wong, MD MPH Community Interventions for Infection Control Unit Division of Global Migration & Quarantine Centers for Disease Control and Prevention MedicalResearch.com: What are the main findings of the study? Dr. Wong: There were 830 pediatric influenza-associated deaths reported to CDC during the 2004–2005 through 2011–2012 seasons; deaths occurred in children of all ages, and 43% had no high-risk medical conditions. Of children 6 months of age or older whose vaccination status was known, only 16% had been fully vaccinated with seasonal influenza vaccine.
Author Interviews, Pediatrics, Vaccine Studies / 22.10.2013

MedicalResearch.com Interview with Katherine Auger, MD, MSc Assistant Professor of Pediatrics Division of Hospital Medicine Cincinnati Children's Hospital Medical Center MedicalResearch.com: What are the main findings of the study? Dr. Auger: We examined hospitalization rates in infants for pertussis before versus after the recommendation to universally vaccinate all adolescents with Tdap.  We used mathematical modeling to predict the number of infant hospitalizations that would be expected without the Tdap vaccine policy.  We then compared these predicted numbers to the actual observed numbers of infant hospitalizations.  In 3 of the 4 years after Tdap vaccine policy, there were significantly fewer infant hospitalizations for pertussis than expected base on the predictions.
Author Interviews, JAMA, Pediatrics, Vaccine Studies / 15.10.2013

MedicalResearch.com Interview with: Dr. Ali Rowhani-Rahbar PhD, MD, MPH Kaiser Permanente Vaccine Study Center, Oakland, California University of Washington Department of Epidemiology Health Sciences Seattle, WA 98195Dr. Ali Rowhani-Rahbar PhD, MD, MPH Kaiser Permanente Vaccine Study Center, Oakland, California University of Washington Department of Epidemiology Health Sciences Seattle, WA 98195   MedicalResearch.com: What are the main findings of your study? Answer: We found that the magnitude of increased risk of fever and seizures following immunization with the first dose of measles-containing vaccines during the second year of life depends on age.  Specifically, the risk of seizures attributable to the vaccine during the 7 to 10 days following vaccination was significantly greater among children 16-23 months of age (9.5 excess cases per 10,000 doses) than among children 12-15 months of age (4.0 excess cases per 10,000 doses).
Author Interviews, HPV, Vaccine Studies / 12.10.2013

Lisen Arnheim Dahlström, Associate Professor (Docent) Institutionen för medicinsk epidemiologi och biostatistik Department of Medical Epidemiology and Biostatistics Karolinska Institutet 171 77 Stockholm, SwedenMedicalResearch.com Interview with: Lisen Arnheim Dahlström, Associate Professor (Docent) Institutionen för medicinsk epidemiologi och biostatistik Department of Medical Epidemiology and Biostatistics Karolinska Institutet 171 77 Stockholm, Sweden   MedicalResearch.com: What are the main findings of the study? Answer: This is a Swedish/Danish population-based study comparing serious disease outcomes in girls immunized with the quadrivalent HPV vaccine against the unvaccinated population. The main finding of this study was that none of the 53 outcomes included in the study were more common in the vaccinated population compared to the non-vaccinated population.
Author Interviews, JAMA, Pediatrics, Rheumatology, Vaccine Studies / 19.06.2013

Marloes Heijstek MD University Medical Center, Wilhelmina Children's Hospital Department of Pediatric Immunology and Rheumatology Room number KC 03.063.0 P.O. Box 85090 Lundlaan 6 3508 AB UtrechtMedicalResearch.com Interview with: Marloes Heijstek MD University Medical Center, Wilhelmina Children's Hospital Department of Pediatric Immunology and Rheumatology Room number KC 03.063.0 P.O. Box 85090 Lundlaan 6 3508 AB Utrecht MedicalResearch.com: What are the main findings of the study? Dr. Heijstek: The main findings of our study are that MMR booster vaccination does not affect JIA disease, does not cause flares of arthritis and induces high rates of protective immunity.
Author Interviews, Infections, Lancet, Vaccine Studies / 31.05.2013

MedicalResearch.com eInterview with: Fengcai Zhu Deputy Director of the Jiangsu Provincial Center for Disease Prevention and Control, Jiangsu provincial center for disease prevention and control

Fengcai Zhu

Deputy Director of the Jiangsu Provincial Center for Disease Prevention and Control, Jiangsu provincial center for disease prevention and control

MedicalResearch.com Editor's Note: HFMD = Hand Foot and Mouth Disease Hand Foot and Mouth Disease

MedicalResearch.com: What are the main findings of the study? Answer: From this trial, the inactivated alum-adjuvant EV71 vaccine showed a good protection for both the EV71-associated HFMD and EV71-associated disease. The vaccine gave 90% protection against clinical EV71-associated HFMD and 80.4% against EV71-associated disease (including neurological complications) for at least 12 months. The safety profile and immunogenicity of this vaccine is proved to be clinical acceptable. We also proposed a titre (1:32) of neutralization antibody as surrogate of protection against EV71-associated disease.