Enterovirus infections remain a major public health concern in Taiwan, particularly in young children. Among various serotypes, enterovirus A71 (EV-A71) is associated with severe neurological complications and high mortality and thus poses substantial challenges to pediatric care and healthcare systems. During the COVID-19 pandemic, widespread nonpharmaceutical interventions, such as mask-wearing, enhanced hand hygiene, and social distancing, led to an unprecedented decline in enterovirus circulation. However, this prolonged suppression also resulted in an “immunity debt,” characterized by reduced population-level immunity and an increased proportion of susceptible children. With the relaxation of pandemic control measures, enterovirus activity resurged, highlighting an urgent need for comprehensive and sustainable infection prevention strategies. In response to the long-standing burden of EV-A71, Taiwan successfully developed and licensed two inactivated EV A71 vaccines in 2023. Clinical trials demonstrated these vaccines’ high immunogenicity and efficacy exceeding 90% in preventing EV-A71-associated disease, highlighting their ability to mitigate severe outcomes in young children. This article reviews the epidemiology of enterovirus infections, the implications of immunity debt in the postpandemic era, and the evidence supporting EV-A71 vaccination. It also emphasizes the importance of integrating vaccination programs into infection prevention and control measures, real-time surveillance, and quality improvement initiatives in healthcare systems. Strengthening vaccination coverage, vigilantly monitoring for severe disease warning signs, and utilizing digital tools for monitoring and quality management are essential for reducing enterovirus-related morbidity and mortality. A coordinated approach combining immunization, infection control, and healthcare quality improvement is crucial for protecting children’s health in the post-COVID-19 era.
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