Changes in Otitis Media Episodes and Pressure Equalization Tube Insertions Among Young Children Following Introduction of the 13-Valent Pneumococcal Conjugate Vaccine: A Birth Cohort–based Study. (16th February 2019)

• Record Type: Journal Article
• Authors: Wiese, Andrew D; Huang, Xiang; Yu, Chang; Mitchel, Edward F; Kyaw, Moe H; Griffin, Marie R; Grijalva, Carlos G
• Is Part Of: Clinical infectious diseases. Volume 69:Number 12(2019)
• Page Start: 2162
• Page End: 2169
• Publication Date: 2019-02-16
• Subjects: otitis media -- pressure equalization tube insertions -- tympanostomy tube placement -- grommets -- pneumococcal conjugate vaccines; Communicable diseases -- Periodicals; 616.905
• DOI: 10.1093/cid/ciz142
• Languages: English
• ISSNs: 1058-4838

Abstract

Abstract: Background: The impact of 13-valent pneumococcal conjugate vaccine (PCV13) introduction on the occurrence of first and subsequent otitis media (OM) episodes in early childhood is unclear. We compared the risk of OM episodes among children age <2 years before and after PCV13 introduction, accounting for the dependence between OM episodes. Methods: We identified consecutive annual (July–June) cohorts of Tennessee Medicaid–enrolled children (2006–2014) from birth through age 2 years. We identified OM episodes using coded diagnoses (we classified diagnoses <21 days apart as the same episode). We modeled adjusted hazard ratios (aHRs) for OM comparing 7-valent pneumococcal conjugate vaccine (PCV7)–era (2006–2010) and PCV13-era (2011–2014) birth cohorts, accounting for risk factors and dependence between first and subsequent episodes. Secondary analyses examined pressure equalization tube (PET) insertions and compared the risk of recurrent OM (≥3 episodes in 6 months or ≥4 episodes in 12 months) between PCV7- and PCV13-era birth cohorts. Results: We observed 618 968 OM episodes and 24 875 PET insertions among 368 063 children. OM and PET insertion rates increased during the PCV7 years and declined after PCV13 introduction. OM and PET insertion risks were lower in the 2013–2014 cohort compared with the 2009–2010 cohort (aHRs [95% confidence interval], 0.92 [.91–.93] and 0.76 [.72–.80], respectively). PCV13 introduction was associated with declines in the risk of first, subsequent, and recurrent OM. Conclusions: The transition from PCV7 to PCV13 was associated with a decline of OM among children aged <2 years due to a reduction in the risk of both the first and subsequent OM episodes. Abstract : The transition from 7-valent to 13-valent pneumococcal conjugate vaccine was associated with an 8% decrease in the risk of otitis media and a 24% decrease in the risk of pressure equalization tube insertions among children <2 years of age.