ACUTE OTITIS MEDIA

Pneumococcal Vaccine Deemed Effective for Acute Otitis Media

June 25, 2018

The 13-valent pneumococcal conjugate vaccine (PCV13) is safe and effective for the prevention of acute otitis media caused by Streptococcus pneumonae (S pneumonae) in young children, according to new findings.

Researchers arrived at this conclusion following a study of 239 children aged 30 months and younger who had been administered the full primary series of PCV13 with other recommended vaccines. The study took place from September 28, 2010 to September 30, 2013. Follow-up occurred at age 30 to 36 months.
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Middle-ear fluid (MEF) was collected via tympanocentesis to identify cases of acute otitis media. MEF was subsequently assessed for the serotypes common to PCV7 and PCV13—4, 6B, 9V, 14, 18C, 19F, and 23F—along with 6 additional serotypes specific to PCV13—1, 3, 5, 6A, 7F, and 19A.

In addition, 348 children enrolled in a longitudinal study in the same center from October 1, 2007, to September 30, 2009, served as controls. All controls included in the study had received the 7-valent pneumococcal conjugate vaccine (PCV7), had MEF collected at acute otitis media onset, and been followed until age 30 months.

Approximately 162 children in the PCV13 cohort and 248 children in the PCV7 cohort were included in the present analysis. Results of the study showed that 53 (24%) of 223 MEF samples obtained from children in the PCV13 cohort at acute otitis media onset were culture positive for S pneumoniae, compared with 89 (31%) of 284 MEF samples obtained from children the PCV7 cohort.

Pneumococci expressing one of the additional PCV13 capsular serotypes were present in 4 (8%) of 53 MEF samples from children the PCV13 cohort vs 46 (52%) of 89 samples from children in the PCV7 cohort (relative reduction 86%).

The researchers also found that the greatest reduction in MEF samples was in serotype 19A, with a relative reduction of 91% (2 [4%] in the PCV13 cohort vs 46 [52%] in the PCV7 cohort).

“PCV13 prevents acute otitis media caused by S pneumoniae expressing serotypes included in the vaccine,” the researchers concluded.

—Christina Vogt

Reference:

Pichichero M, Kaur R, Scott DA, et al. Effectiveness of 13-valent pneumococcal conjugate vaccination for protection against acute otitis media caused by Streptococcus pneumoniae in healthy young children: a prospective observational study [Published online June 18, 2018]. Lancet Child Adolesc Health. https://doi.org/10.1016/S2352-4642(18)30168-8