Pneumococcal vaccines help prevent otitis media

Otitis media is one of the most common reason for a young child’s visit to the pediatrician’s office. The advent of the pneumococcal vaccine has had an impact on the otopathogens that cause otitis media. However, the serotype-specific effectiveness of the 7- and 13-valent pneumococcal vaccines is little known, especially because of the lack of culture-positive cases. A report in Clinical Infectious Disease offers some answers.¹

Investigators ran a study from October 2009 to July 2013. It included all cases of children aged 5 to 35 months who had otitis media who had a middle-ear fluid culture collected. Most of the otitis media cases included in the study were complex and were either recurrent/non-responsive, spontaneously draining, or chronic with effusion. The controls were peers who had rotavirus-negative gastroenteritis and had a similar ethnic distribution and geographic location as the children with otitis media.

There were a total of 223 otitis media cases and 1370 control subjects included in the study. The investigators found that serotypes 19F and 19A were responsible for 56.1% of all vaccine-serotype otitis media. The efficacy of the 7-valent vaccine against otitis media due the 7-valent vaccine serotypes was 57.2% and the 13-valent vaccine against otitis media due the 13-valent vaccine serotypes was 77.4%. Additionally, the 13-valent pneumococcal vaccine had 67.4% efficacy for six non-valent 7 serotypes; 91.3% against serotype 19A-otitis media.

The investigators concluded that both the 7-valent and 13-valent pneumococcal vaccines were effective in preventing complex otitis media that was triggered by the targeted serotypes. A key limitation to the study was the fact that children with uncomplicated acute otitis media were not included in the study, likely due to the lack of culture collection in such cases.

Reference

1. Dagan R, van der Beek B, Ben-Shimol S, Pilishvili T, Givon-Lavi N. Effectiveness of the seven- and thirteen valent pneumococcal conjugate vaccines against vaccine-serotype otitis media. Clinical Infectious Diseases. 2021. doi:10.1093/cid/ciab066