Pneumococcal Conjugated Vaccines Decreased Acute Otitis Media Burden: A Population-Based Study in Israel

Marom, Tal; Tshori, Sagi; Shefer, Galit; Pitaro, Jacob

doi:10.1016/j.jpeds.2021.04.025

Cited by 14 publications

(13 citation statements)

References 36 publications

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“…In our study we found the incidence of AOM to be highest in the < 2 years age group compared to children aged 2–4 and 5–17 years. This is consistent with the Israeli and Swedish studies mentioned above [ 3 , 40 ]. In Israel, children aged 0–1 and 1–2 years had the highest AOM episode rates in the pre-PCV years and the post-PCV years compared to children aged > 2 and < 9 years [ 40 ].…”

Section: Discussionsupporting

confidence: 93%

“…This is consistent with the Israeli and Swedish studies mentioned above [ 3 , 40 ]. In Israel, children aged 0–1 and 1–2 years had the highest AOM episode rates in the pre-PCV years and the post-PCV years compared to children aged > 2 and < 9 years [ 40 ]. In Sweden, children aged ≤2 years had the highest IRs across all the study years compared to older children [ 3 ].…”

Section: Discussionsupporting

confidence: 93%

“…Other studies, elsewhere, have also observed significant declines in AOM incidence in the post-PCV era. A recent study in Israel demonstrated a downward trend in AOM IRs during the post-PCV years in children aged < 9 years (August 2009–2018; p -value < 0.001) with the largest decrease observed in children aged < 1 year [ 40 ]. Similar decreasing trends have also been observed in Sweden from 2005 to 2013 in children aged ≤5 years: with a 2.3% decrease in OM and AOM following PCV13 introduction [ 3 ].…”

Section: Discussionmentioning

confidence: 99%

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Incidence of acute otitis media from 2003 to 2019 in children ≤ 17 years in England

et al. 2023

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Background The 7-valent pneumococcal conjugate vaccine (PCV7) was introduced in 2006 and the 13-valent pneumococcal conjugate vaccine (PCV13) in 2010 in the UK. PCVs are active immunization for the prevention of invasive disease, pneumonia and acute otitis media (AOM) caused by Streptococcus pneumoniae in children. The aim of this observational study was to estimate incidence rates (IRs) of AOM in children ≤17 years from 2003 to 2019 in England, before and after the introduction of pneumococcal conjugate vaccines (PCVs). Methods AOM episodes were identified using Read diagnosis codes in children aged ≤17 years in the Clinical Practice Research Datalink (CPRD) Gold database from 2003 to 2019. Annual IRs with 95% confidence intervals (CI) by age group were calculated as the number of episodes/person-years (PY) at risk. Interrupted time series analyses were conducted to estimate incidence rate ratios (IRR) across post-PCV7 (2007–2009), early post-PCV13 (2011–2014) and late post-PCV13 (2015–2019) periods compared to the pre-PCV7 period (2003–2005) using generalized linear models. Results From 2003 to 2019, 274,008 all-cause AOM episodes were identified in 1,500,686 children. The overall AOM IR was 3690.9 (95% CI 3677.1-3704.8) per 100,000 PY. AOM IRs were highest in children aged < 5 years and decreased by age; < 2 years: 8286.7 (95% CI 8216.8-8357.1); 2–4 years: 7951.8 (95% CI 7902.5-8001.4); 5–17 years: 2184.4 (95% CI 2172.1–2196.8) (per 100,000 PY). Overall AOM IRs declined by 40.3% between the pre-PCV7 period and the late-PCV13 period from 4451.9 (95% CI 4418.1-4485.9) to 2658.5 (95% CI 2628.6-2688.7) per 100,000 PY, and across all age groups. IRRs indicated a significant decrease in AOM IRs in all the post-vaccination periods, compared to the pre-PCV7 period: post-PCV7 0.87 (95% CI 0.85–0.89), early post-PCV13 0.88 (95% CI 0.86–0.91), and late post-PCV13 0.75 (95% CI 0.73–0.78). Conclusions The AOM IRs declined during the 2003–2019 period; however, the clinical burden of AOM remains substantial among children ≤17 years in England.

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Section: Discussionsupporting

confidence: 93%

Section: Discussionsupporting

confidence: 93%

Section: Discussionmentioning

confidence: 99%

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Incidence of acute otitis media from 2003 to 2019 in children ≤ 17 years in England

et al. 2023

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“…Other studies have observed significant declines in AOM IRs in children following PCV introduction. A recent study in Israel demonstrated a downward trend of IRs of AOM during the post-PCV years in children aged < 9 years (August 2009–2018; P < 0.001) [ 39 ]. The largest decrease (21%) was observed in children aged < 1 year, from 807/ 1,000 children during the pre-PCV years to 640/ 1,000 during the post-PCV years ( P < 0.001).…”

Section: Discussionmentioning

confidence: 99%

Incidence of acute otitis media in children < 16 years old in Germany during 2014–2019

Podmore

Barnett

et al. 2022

BMC Pediatr

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Background Acute otitis media (AOM) remains a common infection in children despite the introduction of pneumococcal conjugate vaccines. This study estimated AOM incidence rates (IRs) over time in children < 16 years old in Germany following PCV13 introduction. Methods AOM episodes were identified in the InGef healthcare claims database from 2014–2019 in children aged < 16 years. Each AOM episode was classified as either simple or recurrent. Recurrent AOM was defined as 3 or more episodes identified within a 6-month period; or 4 or more episodes within a 12-month period with at least one episode in the prior 6 months. AOM-related surgical procedures within 12 months and complications within 21 days of an AOM episode were also identified. Annual IRs were calculated as number of episodes/child-years (CY) at risk. 95% Confidence intervals (95%CI) were calculated using the Wilson method. The Mann–Kendall test was used to assess trends over time. Results Between 2014 and 2019, the study population comprised 916,805 children with 327,726 AOM episodes, of which 15% (49,011) of all episodes were identified as recurrent AOM and 85% (278,715) as simple AOM. There were significant declines in AOM (p = 0.003) in the study population overall and in all age groups over the study period; from 101 (95%CI 101–102)/1000 CY to 79 (95%CI 78–80)/1000 CY in the total study population, from 209 (95%CI 206–212)/1000 CY to 147 (95%CI 145–150)/1000 CY in < 2-year-olds, from 239 (95%CI 237–242) to 179 (95%CI 177–182)/1000 CY in 2–4-year-olds, and from 50 (95%CI 49–50) to 38 (95%CI 37–39)/1000 CY in 5–15-year-olds. No significant trends were identified for AOM-related surgical procedures over the study period; however, AOM-related complications overall increased (p = 0.003). Conclusion Between 2014 and 2019, AOM incidence overall declined in children aged 0–15 years in Germany. Over the study period, the incidence of complicated AOM cases increased, however the incidence of AOM-related surgical procedures remained constant. Despite the impact of PCV13, the burden associated with AOM in Germany remains substantial.

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“…1 , 7 Vaccine-type invasive pneumococcal disease (IPD) and non-invasive pneumococcal disease in children have been reduced substantially where pneumococcal conjugate vaccine (PCV) has been used. 8 , 9 The World Health Organization (WHO) recommended the inclusion of PCVs in childhood immunization programmes across the world, 1 and as of 2021, 158 of 194 WHO member countries and regions had included childhood vaccination against pneumococcus in the National Immunization Programme (NIP). 10 China has yet to introduce a publicly funded PCV program for young children.…”

Section: Introductionmentioning

confidence: 99%

Estimating national, regional and provincial cost-effectiveness of introducing childhood 13-valent pneumococcal conjugate vaccination in China: a modelling analysis

Lai

Garcia²,

Wu³

et al. 2023

The Lancet Regional Health - Western Pacific

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Pneumococcal Conjugated Vaccines Decreased Acute Otitis Media Burden: A Population-Based Study in Israel

Cited by 14 publications

References 36 publications

Incidence of acute otitis media from 2003 to 2019 in children ≤ 17 years in England

Incidence of acute otitis media from 2003 to 2019 in children ≤ 17 years in England

Incidence of acute otitis media in children < 16 years old in Germany during 2014–2019

Estimating national, regional and provincial cost-effectiveness of introducing childhood 13-valent pneumococcal conjugate vaccination in China: a modelling analysis

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