Head JR, Collender PA, Lewnard JA, et al. - Given the association of enterovirus 71 (EV71), a major causative agent of hand, foot, and mouth disease (HFMD), with severe manifestations of the disease, initiation of pediatric immunization with inactivated EV71 vaccine was undertaken in 2016 in the Asia-Pacific Region, including China. Researchers here assessed China’s notifiable disease surveillance system for reported HFMD cases attributable to EV71, coxsackievirus A16, and other enteroviruses in Chengdu, a major transmission center in China, in order to determine early impressions of immunization. They identified reports of 279,352 HFMD cases from 2011 to 2018. In 2017-2018, EV71 HFMD incidence of 60% (95% prediction interval (PI): 41%–72%) was reported which is lower than predicted in the absence of immunization, corresponding to an estimated 6,911 (95% PI: 3,246, 11,542) EV71 cases prevented over 2 years. This first real-world evidence supports the efficacy of programmatic vaccination against EV71 against childhood HFMD and proposes a way to discover early vaccine impact or expected consequences from surveillance data.