Efficacy of Pneumococcal Vaccine on Otitis Media: A Systematic Review and Meta‐Analysis

Abstract

ObjectiveTo assess the effect of the pneumococcal vaccine (PCV) toward the surgical management and complications of otitis media.Data SourcesMEDLINE, EMBASE, PubMed, Scopus, and clinicaltrial.gov.Review MethodsA systematic search was performed using a combination of keywords and standardized terms about PCV and surgical management or complications of otitis media. Following Preferred Reporting Items for Systematic Reviews and Meta‐Analyses guidelines, studies were screened by 3 independent reviewers. Risk of bias assessment, followed by meta‐analysis in only randomized‐controlled trials was conducted. Vaccine efficacy (VE) and 95% confidence interval (CI) were reported.ResultsOf the 2649 abstracts reviewed, 27 studies were included in the qualitative analysis and were categorized into 6 outcomes: tympanostomy tube insertion, otitis media with effusion (OME), mastoiditis, spontaneous tympanic membrane (TM) perforation, recurrent acute otitis media (AOM), and severe AOM. Fifteen studies were included in the meta‐analysis to evaluate the rate of tympanostomy tube insertion, OME, and recurrent AOM. PCV was significantly more effective in lowering the rate of tympanostomy tube insertion (VE, 22.2%; 95% CI, 14.6‐29.8) and recurrent AOM (VE, 10.06%; 95% CI, 7.46‐12.65) when compared with the control group, with no significant difference in reducing the incidence of OME. The qualitative analysis revealed that PCV had efficacy in preventing severe AOM and spontaneous TM perforation but the effect on mastoiditis remained unclear.ConclusionThe PCV was effective in reducing the rate of tympanostomy tube insertion and the incidence of recurrent AOM with a nonsignificant effect in preventing OME in children.

Global, Regional, and National Burdens of Otitis Media From 1990 to 2019: A Population Based Study

“…Indeed, we should also acknowledge that apart from vaccination, changes in environmental factors and socioeconomic disparities can also impact the variations in the burden of otitis media. Between the years 2010 and 2019, following the introduction of PHiD-CV and PCV-13, we observed a consistent reduction in the burden of otitis media aligning with previous research findings ( Izurieta et al 2022 ; Wannarong et al 2023 ). Nevertheless, this study identified an upward trend in the global incidence of otitis media from 2014 to 2017.…”

Antibiotic treatment to prevent pediatric acute otitis media infectious complications: A meta-analysis

“…Only 7 studies reported pneumococcal vaccination rates, so the impact of vaccination on the development of these outcomes was not assessed. However, recent studies have shown that while pneumococcal vaccines have decreased the number of AOM episodes, the number of otitis-prone children [ 76 ], and overall rates of invasive pneumococcal disease [ 77 , 78 ], the impact on acute mastoiditis is less clear, with one recent study showing an increase in acute mastoiditis by other Gram positive bacteria [ 79 ].…”