Otitis Media Episodes Down After Introduction of PCV13

By Will Boggs MD

March 11, 2019

NEW YORK (Reuters Health) - Otitis media episodes and pressure equalization tube (PET) insertions have dropped since the introduction of the 13-valent pneumococcal conjugate vaccine (PCV13), researchers report.

"Otitis media is a leading cause of healthcare use and a leading cause of antibiotic use among children," said Dr. Andrew D. Wiese from Vanderbilt University Medical Center, in Nashville, Tennessee.

"The switch from the 7-valent to the 13-valent pneumococcal conjugate vaccine led to important and significant reductions in the population-level burden of this common disease," he told Reuters Health by email. "Nevertheless, despite these changes, the burden of otitis media remains substantial and additional preventative interventions are needed."

Introduction of the seven-valent pneumococcal conjugate vaccine (PCV7) into the U.S. infant vaccination schedule in 2000 was associated with reductions in all-cause of otitis media and PET insertion procedures.

Dr. Wiese's team investigated whether a further drop would follow the transition from PCV7 to PCV13 in 2010 among more than 368,000 children <2 years old enrolled in Tennessee Medicaid.

The incidence of acute otitis media episodes per 100 person-years increased during the PCV7 era (from 88.6 in 2006-2007 to 98.6 in 2009-2010), but decreased during the PCV13 era (from 98.1 in 2011-2012 to 89.3 in 2013-2014), the team reports in Clinical Infectious Diseases, online February 16.

Total PET procedures increased during the PCV7 era and decreased during the PCV13 era, and the risk of recurrent otitis media followed the same pattern.

After adjustment for other factors, the risk of otitis media was 8% lower in the most recent PCV13 birth cohort (2013-2014) than in the last PCV7 birth cohort (2009-2010). The risk of PET insertion procedures was 24% lower in 2013-2014 than in 2009-2010.

While these improvements were consistent among boys and girls, boys had consistently higher rates of otitis media and PET insertion procedures than girls did throughout the study period.

"Vaccination with PCV13 is an effective and important strategy for the prevention of otitis media among young children," Dr. Wiese concluded. "This study adds to the existing knowledge that PCV13 is also effective in the prevention of childhood invasive pneumococcal diseases and pneumonia hospitalizations."

Sanofi-Pasteur supported the study, employed one of Dr. Wiese's coauthors and had various relationships with another.

SOURCE: https://bit.ly/2C81iD6

Clin Infect Dis 2019.

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