Epidemiological shifts in coxsackievirus A-induced hand, foot, and mouth disease in China, 2008–2024

Post-vaccination, EV-A71 incidence declined markedly, while CV-A6, CV-A10, CV-A16, and CV-A4 gradually became predominant, exhibiting distinct geographic and seasonal distributions. These findings underscore the evolving HFMD epidemiology in China and highlight the need for multivalent vaccines and sustained surveillance to effectively control HFMD.