Which vaccines have reduced the incidence of acute otitis media (AOM) in children?

Updated: Sep 25, 2019
  • Author: John D Donaldson, MD, FRCSC, FACS; Chief Editor: Arlen D Meyers, MD, MBA  more...
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Since the introduction of the heptavalent pneumococcal vaccine in 2000, researchers have found that nearly two thirds of invasive pneumococcal disease cases in young children have been caused by 6 serotypes that were not included in that vaccine. Those serotypes, along with the original 7, have been incorporated into pneumococcal vaccine valent-13 (Prevnar 13) that was approved in February 2010.

A study by Hasegawa et al indicated that the introduction of a heptavalent pneumococcal conjugate vaccine to Japan in 2009 significantly reduced the risk of AOM in infants and young children. The study, in which 614 parents were surveyed, found that, after adjustment for potentially confounding variables, the hazard ratio for AOM in vaccinated children was 0.33, with significant risk reduction in children between infancy and age 3 years and in young children over age 3 years. [29]

Similarly, a study by Tawfik et al indicated that since the introduction of pneumococcal vaccination, hospital admissions for pediatric AOM/complications of AOM in the United States have decreased in prevalence, as have admission rates for pediatric pneumococcal meningitis with AOM/complications of AOM. Using information from the Kids’ Inpatient Database from between 2000 and 2012, the study found particularly sharp declines in admissions for children under age 1 years, from 22.647 to 8.715 per 100,000 persons, and for children aged 1-2 years, from 13.652 to 5.554 per 100,000 persons. [30]

A study by Kaur et al indicated that the introduction of 7-valent and 13-valent pneumococcal conjugate vaccine (PCV7 and PCV13) has reduced the prevalence of AOM in children aged 3 years or younger. The report found that out of 615 children, all of whom were vaccinated with PCV7 or PCV13, 60% suffered one or more episodes of AOM by age 3 years, and 24% experienced three or more episodes. In comparison, a 1989 study, conducted by Teele et al prior to the introduction of PCVs, found that by age 3 years, 83% of children followed experienced at least one episode of AOM, while 46% suffered three or more episodes. Kaur et al also attributed the change in AOM prevalence to more stringent criteria used to differentiate AOM from otitis media with effusion. [31, 32, 33]

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