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Changes in Otitis Media Episodes and Pressure Equalization Tube Insertions Among Young Children Following Introduction of the 13-Valent Pneumococcal Conjugate Vaccine: A Birth Cohort-based Study.
Clin Infect Dis. 2019 11 27; 69(12):2162-2169.CI

Abstract

BACKGROUND

The impact of 13-valent pneumococcal conjugate vaccine (PCV13) introduction on the occurrence of first and subsequent otitis media (OM) episodes in early childhood is unclear. We compared the risk of OM episodes among children age <2 years before and after PCV13 introduction, accounting for the dependence between OM episodes.

METHODS

We identified consecutive annual (July-June) cohorts of Tennessee Medicaid-enrolled children (2006-2014) from birth through age 2 years. We identified OM episodes using coded diagnoses (we classified diagnoses <21 days apart as the same episode). We modeled adjusted hazard ratios (aHRs) for OM comparing 7-valent pneumococcal conjugate vaccine (PCV7)-era (2006-2010) and PCV13-era (2011-2014) birth cohorts, accounting for risk factors and dependence between first and subsequent episodes. Secondary analyses examined pressure equalization tube (PET) insertions and compared the risk of recurrent OM (≥3 episodes in 6 months or ≥4 episodes in 12 months) between PCV7- and PCV13-era birth cohorts.

RESULTS

We observed 618 968 OM episodes and 24 875 PET insertions among 368 063 children. OM and PET insertion rates increased during the PCV7 years and declined after PCV13 introduction. OM and PET insertion risks were lower in the 2013-2014 cohort compared with the 2009-2010 cohort (aHRs [95% confidence interval], 0.92 [.91-.93] and 0.76 [.72-.80], respectively). PCV13 introduction was associated with declines in the risk of first, subsequent, and recurrent OM.

CONCLUSIONS

The transition from PCV7 to PCV13 was associated with a decline of OM among children aged <2 years due to a reduction in the risk of both the first and subsequent OM episodes.

Authors+Show Affiliations

Department of Health Policy, Vanderbilt University Medical Center, Nashville, Tennessee.Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee.Department of Biostatistics, Vanderbilt University Medical Center, Nashville, Tennessee.Department of Health Policy, Vanderbilt University Medical Center, Nashville, Tennessee.Sanofi Pasteur, Swiftwater, PA.Department of Health Policy, Vanderbilt University Medical Center, Nashville, Tennessee.Department of Health Policy, Vanderbilt University Medical Center, Nashville, Tennessee.

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

30770533

Citation

Wiese, Andrew D., et al. "Changes in Otitis Media Episodes and Pressure Equalization Tube Insertions Among Young Children Following Introduction of the 13-Valent Pneumococcal Conjugate Vaccine: a Birth Cohort-based Study." Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America, vol. 69, no. 12, 2019, pp. 2162-2169.
Wiese AD, Huang X, Yu C, et al. Changes in Otitis Media Episodes and Pressure Equalization Tube Insertions Among Young Children Following Introduction of the 13-Valent Pneumococcal Conjugate Vaccine: A Birth Cohort-based Study. Clin Infect Dis. 2019;69(12):2162-2169.
Wiese, A. D., Huang, X., Yu, C., Mitchel, E. F., Kyaw, M. H., Griffin, M. R., & Grijalva, C. G. (2019). Changes in Otitis Media Episodes and Pressure Equalization Tube Insertions Among Young Children Following Introduction of the 13-Valent Pneumococcal Conjugate Vaccine: A Birth Cohort-based Study. Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America, 69(12), 2162-2169. https://doi.org/10.1093/cid/ciz142
Wiese AD, et al. Changes in Otitis Media Episodes and Pressure Equalization Tube Insertions Among Young Children Following Introduction of the 13-Valent Pneumococcal Conjugate Vaccine: a Birth Cohort-based Study. Clin Infect Dis. 2019 11 27;69(12):2162-2169. PubMed PMID: 30770533.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Changes in Otitis Media Episodes and Pressure Equalization Tube Insertions Among Young Children Following Introduction of the 13-Valent Pneumococcal Conjugate Vaccine: A Birth Cohort-based Study. AU - Wiese,Andrew D, AU - Huang,Xiang, AU - Yu,Chang, AU - Mitchel,Edward F, AU - Kyaw,Moe H, AU - Griffin,Marie R, AU - Grijalva,Carlos G, PY - 2018/10/30/received PY - 2019/02/11/accepted PY - 2019/2/17/pubmed PY - 2020/9/20/medline PY - 2019/2/17/entrez KW - grommets KW - otitis media KW - pneumococcal conjugate vaccines KW - pressure equalization tube insertions KW - tympanostomy tube placement SP - 2162 EP - 2169 JF - Clinical infectious diseases : an official publication of the Infectious Diseases Society of America JO - Clin Infect Dis VL - 69 IS - 12 N2 - BACKGROUND: The impact of 13-valent pneumococcal conjugate vaccine (PCV13) introduction on the occurrence of first and subsequent otitis media (OM) episodes in early childhood is unclear. We compared the risk of OM episodes among children age <2 years before and after PCV13 introduction, accounting for the dependence between OM episodes. METHODS: We identified consecutive annual (July-June) cohorts of Tennessee Medicaid-enrolled children (2006-2014) from birth through age 2 years. We identified OM episodes using coded diagnoses (we classified diagnoses <21 days apart as the same episode). We modeled adjusted hazard ratios (aHRs) for OM comparing 7-valent pneumococcal conjugate vaccine (PCV7)-era (2006-2010) and PCV13-era (2011-2014) birth cohorts, accounting for risk factors and dependence between first and subsequent episodes. Secondary analyses examined pressure equalization tube (PET) insertions and compared the risk of recurrent OM (≥3 episodes in 6 months or ≥4 episodes in 12 months) between PCV7- and PCV13-era birth cohorts. RESULTS: We observed 618 968 OM episodes and 24 875 PET insertions among 368 063 children. OM and PET insertion rates increased during the PCV7 years and declined after PCV13 introduction. OM and PET insertion risks were lower in the 2013-2014 cohort compared with the 2009-2010 cohort (aHRs [95% confidence interval], 0.92 [.91-.93] and 0.76 [.72-.80], respectively). PCV13 introduction was associated with declines in the risk of first, subsequent, and recurrent OM. CONCLUSIONS: The transition from PCV7 to PCV13 was associated with a decline of OM among children aged <2 years due to a reduction in the risk of both the first and subsequent OM episodes. SN - 1537-6591 UR - https://www.unboundmedicine.com/medline/citation/30770533/Changes_in_Otitis_Media_Episodes_and_Pressure_Equalization_Tube_Insertions_Among_Young_Children_Following_Introduction_of_the_13_Valent_Pneumococcal_Conjugate_Vaccine:_A_Birth_Cohort_based_Study_ L2 - https://academic.oup.com/cid/article-lookup/doi/10.1093/cid/ciz142 DB - PRIME DP - Unbound Medicine ER -