Reduction in All-Cause Acute Otitis Media in Children <3 Years of Age in Primary Care Following Vaccination With 10-Valent Pneumococcal Haemophilus influenzae Protein-D Conjugate Vaccine: A Whole-Population Study.

• Published in: Clinical Infectious Diseases
• Main Authors: Sigurdsson, Samuel, Eythorsson, Elias, Hrafnkelsson, Birgir, Erlendsdóttir, Helga, Kristinsson, Karl G, Haraldsson, Ásgeir
• Other Authors: 1 Faculty of Medicine, University of Iceland. 2 Department of Mathematics, University of Iceland. 3 Department of Clinical Microbiology, Reykjavík. 4 Children's Hospital Iceland, Landspítali University Hospital, Reykjavík.
• Format: Article in Journal/Newspaper
• Language: English
• Published: Oxford University Press 2018
• Subjects: Eyrnabólga; Bólusetningar; Otitis Media; Vaccines; Haemophilus Vaccines; Iceland
• Online Access: http://hdl.handle.net/2336/620735; https://doi.org/10.1093/cid/ciy233

To access publisher's full text version of this article click on the hyperlink below The 10-valent pneumococcal conjugate vaccine (PHiD-CV10) was introduced in Iceland in 2011, without catch-up. The aim of this study was to estimate vaccine impact (VI) on acute otitis media (AOM). In this whole-population study, all primary care visits due to AOM from 2005 to 2015 in children <3 years of age were included. Birth cohorts were grouped as vaccine noneligible (VNEC) or vaccine eligible (VEC). Crude incidence rates (IRs) were compared between the VNEC and VEC. A Cox regression model for repeated events was used to model the individual-level data. VI was calculated as (hazard ratio [HR] - 1) × 100%. Included were 53150 children, with 140912 person-years of follow-up and 58794 AOM episodes. Both IR and the mean number of episodes differed significantly between VNEC and VEC; 43 compared to 38 episodes per 100 person-years and 1.61 episodes per child compared to 1.37. IR was significantly reduced in all age brackets, with the largest reduction in children <4 months of age (40% [95% confidence interval {CI}, 31%-49%). The VI on all-cause AOM was 22% (95% CI, 12%-31%). The impact was mediated through its effect on the first (HR, 0.84 [95% CI, .82-.86]) and second (HR, 0.95 [95% CI, .93-.98]) episodes. The impact of PHiD-CV10 on all-cause AOM was considerable, mediated mainly by preventing the first two episodes of AOM. A decrease in the IR of AOM in children too young to receive direct vaccine protection was demonstrated, suggesting herd effect. GlaxoSmithKline Biologicals SA Landspitali University Hospital Research Fund