Increase in tympanostomy tube placements despite pneumococcal vaccination, a population-based study.

• Published in: Acta Paediatrica
• Main Authors: Eythorsson, Elias, Sigurdsson, Samuel, Erlendsdóttir, Helga, Hrafnkelsson, Birgir, Kristinsson, Karl G, Haraldsson, Ásgeir
• Other Authors: 1 Faculty of Medicine, University of Iceland, Reykjavik, Iceland. 2 Department of Clinical Microbiology, Landspítali University Hospital, Reykjavik, Iceland. 3 Department of Mathematics, University of Iceland, Reykjavik, Iceland. 4 Children's Hospital Iceland, Landspítali University Hospital, Reykjavik, Iceland.
• Format: Article in Journal/Newspaper
• Language: English
• Published: Wiley 2019
• Subjects: Streptococcus pneumoniae; Conjugate vaccines; Middle ear ventilation; Otitis media; PHiD-CV vaccine; Eyrnabólga; Bólusetningar; Pneumococcal Vaccines; Iceland
• Online Access: http://hdl.handle.net/2336/621064; https://doi.org/10.1111/apa.14724

To access publisher's full text version of this article click on the hyperlink below AIM: The aim was to estimate the impact of the 10-valent pneumococcal vaccine (PHiD-CV) on tympanostomy tube placements (TTP) in children under five years of age in Iceland. METHODS: This population-based observational cohort study followed 11 consecutive birth-cohorts 2005-2015 from birth until their fifth birthday. Population registries were merged using national identification numbers. The risk of TTP was compared between birth-cohorts adjusted for the number of previous otitis media diagnoses and antimicrobial prescriptions. A Cox regression model was applied and the hazard ratio (HR) of TTP was estimated between each birth-cohort and the last vaccine non-eligible birth-cohort. The vaccine impact of PHiD-CV10 on TTP was estimated as 1-HR ×100%. RESULTS: In total, 51 247 children were followed for 210 724 person-years, of which 14 351 underwent 20 373 procedures. The estimated vaccine impact on TTP was -6% (95% CI -16% to 2.7%). Children in the vaccine-eligible cohorts had fewer previous otitis media diagnoses and had been prescribed fewer antimicrobials prior to the procedure than children in the vaccine non-eligible cohorts. CONCLUSION: Despite high uptake of PHiD-CV10, tympanostomy procedures increased in Iceland during the study period. Vaccine-eligible children had milder disease prior to the procedure. The reason underlying these findings are speculative. GlaxoSmithKline Biologicals SA Landspitali University Hospital Research Fund