Pneumococcal Vaccine Lowers Rates of Ear Tube Placement

Newswise — A vaccine to prevent infections with pneumococcal bacteria is helping to reduce the rate of ear tube placement for chronic middle ear infections (otitis media) in Australian children, suggests a report in the September issue of The Pediatric Infectious Disease Journal. The journal is published by Lippincott Williams & Wilkins, a part of Wolters Kluwer Health, a leading provider of information and business intelligence for students, professionals, and institutions in medicine, nursing, allied health, and pharmacy.

The reduction in otitis media is one important benefit of pneumococcal vaccination and may be achieved without giving an additional booster dose after age one, concludes the a study led by Andrew Jardine, Ph.D., of The Children's Hospital at Westmead and the University of Sydney.

In Youngest Children, Need for Ear Tubes Drops by Nearly One-FourthAustralia introduced routine pneumococcal vaccination for infants in 2005. To assess the impact on otitis media, the researchers analyzed data on Australian children undergoing ear tube placement (myringotomy with ventilation tube insertion) from 1998 to 2007. Ear tubes are commonly placed in children with chronic or repeated otitis media. By helping drain fluid from the middle ear, the tube may reduce the risk of future infections.

For children under age two, a sharp reduction in the rate of ear tube placement was apparent soon after the start of pneumococcal vaccination. This was on top of a general downward trend in the number of ear tubes placed, resulting from efforts to reduce unnecessary procedures.

After adjusting for this background trend, the researchers found significant decreases in ear tube placement in children under age three—who were born after the start of the pneumococcal vaccine program. The reduction was 23 percent in infants less than one year old, 16 percent in one-year-olds, and six percent in two-year-olds.

In contrast, the rate of ear tube placement in older children (aged five to nine) increased by five percent. The researchers estimated that in the first 30 months of the program, pneumococcal vaccination prevented more than 2,000 ear tube placement procedures in Australian children aged two or younger.

Benefits Achieved Without Booster ShotDr. Jardine and colleagues point out that the reduction in otitis media was achieved by giving three doses of pneumococcal vaccine during the first year of life, without an additional booster dose after age one. Studies from the United States, where a booster shot is recommended, have reported similar reductions in ear tube procedures. The researchers also note that the nationally funded Australian program rapidly achieved very high coverage rates.

Several types of vaccines to prevent childhood infections with pneumococcal bacteria have been introduced in recent years. A growing number of studies have shown that these vaccines prevent several types of serious pneumococcal infections—including pneumonia and meningitis, as well as otitis media.

The new results suggest that, in Australia as in other countries, childhood pneumococcal vaccination has reduced the rate of chronic otitis media requiring ear tube placement. The fact that the sharpest drop occurred in the youngest children supports the theory that the reduction is due to the vaccine's ability to prevent pneumococcal infections. Despite some key limitations, the study also suggests that at least some of the benefits of childhood pneumococcal vaccination can be gained with three doses before age one, without the need for an additional booster shot.

About The Pediatric Infectious Disease JournalThe Pediatric Infectious Disease Journal® (http://www.pidj.com) is a peer-reviewed, multidisciplinary journal directed to physicians and other health care professionals who manage infectious diseases of childhood. The journal delivers the latest insights on all aspects of infectious disease in children, from state-of-art diagnostic techniques to the most effective drug therapies and other essential treatment protocols. The Pediatric Infectious Disease Journal is official journal of the Pediatric Infectious Diseases Society (www.PIDS.org) and the European Society for Paediatric Infectious Diseases (www.ESPID.org).

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