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Effectiveness of the 7- and 13-Valent Pneumococcal Conjugate Vaccines Against Vaccine-Serotype Otitis Media.
Clin Infect Dis. 2021 08 16; 73(4):650-658.CI

Abstract

BACKGROUND

Despite the demonstrated impact of pneumococcal vaccine (PCV) implementation on otitis media (OM), demonstration of real-life serotype-specific effectiveness of the 7-valent and 13-valent PCVs (PCV7 and PCV13) is lacking owing to the paucity of culture-positive cases. Furthermore, prelicensure PCV13 efficacy against OM was not studied.

METHODS

The study was conducted from October 2009 to July 2013. Case patients were children aged 5-35 months with OM (mostly complex OM [recurrent/nonresponsive, spontaneously draining, chronic with effusion]) from whom middle-ear fluid culture was obtained; controls were contemporary children with rotavirus-negative gastroenteritis in a prospective population-based rotavirus surveillance, from the same age group with similar ethnic distribution and geographic location. Vaccine effectiveness (VE) was estimated as 1 minus the odds ratio using unconditional logistic regression, adjusting for time since PCV implementation, age, and ethnicity.

RESULTS

A total of 223 case patients and 1370 controls were studied. Serotypes 19F and 19A together caused 56.1% of all vaccine-type (VT) OM. VE of ≥2 PCV doses in children aged 5-35 months was demonstrated as follows: PCV7 against OM due to PCV7 serotypes, 57.2% (95% confidence interval, 6.0%-80.5%); PCV13 against OM due to PCV13 serotypes, 77.4% (53.3%-92.1%); PCV13 against OM due to the 6 additional non-PCV7 serotypes 67.4% (17.6%-87.1%); PCV13 against OM due to serotype 19F, 91.3% (1.4%-99.2%); and PCV13 against OM due to serotype 3, 85.2% (23.9%-98.4%). PCV7 and PCV13 VE against OM due to serotype 19A in children aged 12-35 months was 72.4% (95% confidence interval, 6.2%-91.9%) and 94.6% (33.9%-99.6%), respectively.

CONCLUSIONS

PCV7 and PCV13 were effective against complex OM caused by the targeted serotypes.

Authors+Show Affiliations

The Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel.The Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel.The Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel. The Pediatric Infectious Disease Unit, Soroka University Medical Center, Beer-Sheva, Israel.Centers for Disease Control and Prevention, Atlanta, Georgia, USA.The Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel. The Pediatric Infectious Disease Unit, Soroka University Medical Center, Beer-Sheva, Israel.

Pub Type(s)

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

Language

eng

PubMed ID

33507250

Citation

Dagan, Ron, et al. "Effectiveness of the 7- and 13-Valent Pneumococcal Conjugate Vaccines Against Vaccine-Serotype Otitis Media." Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America, vol. 73, no. 4, 2021, pp. 650-658.
Dagan R, Van Der Beek BA, Ben-Shimol S, et al. Effectiveness of the 7- and 13-Valent Pneumococcal Conjugate Vaccines Against Vaccine-Serotype Otitis Media. Clin Infect Dis. 2021;73(4):650-658.
Dagan, R., Van Der Beek, B. A., Ben-Shimol, S., Pilishvili, T., & Givon-Lavi, N. (2021). Effectiveness of the 7- and 13-Valent Pneumococcal Conjugate Vaccines Against Vaccine-Serotype Otitis Media. Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America, 73(4), 650-658. https://doi.org/10.1093/cid/ciab066
Dagan R, et al. Effectiveness of the 7- and 13-Valent Pneumococcal Conjugate Vaccines Against Vaccine-Serotype Otitis Media. Clin Infect Dis. 2021 08 16;73(4):650-658. PubMed PMID: 33507250.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Effectiveness of the 7- and 13-Valent Pneumococcal Conjugate Vaccines Against Vaccine-Serotype Otitis Media. AU - Dagan,Ron, AU - Van Der Beek,Bart Adriaan, AU - Ben-Shimol,Shalom, AU - Pilishvili,Tamara, AU - Givon-Lavi,Noga, PY - 2020/10/20/received PY - 2021/1/29/pubmed PY - 2021/9/23/medline PY - 2021/1/28/entrez KW - case-control study KW - effectiveness KW - otitis media KW - pneumococcal conjugate vaccine SP - 650 EP - 658 JF - Clinical infectious diseases : an official publication of the Infectious Diseases Society of America JO - Clin Infect Dis VL - 73 IS - 4 N2 - BACKGROUND: Despite the demonstrated impact of pneumococcal vaccine (PCV) implementation on otitis media (OM), demonstration of real-life serotype-specific effectiveness of the 7-valent and 13-valent PCVs (PCV7 and PCV13) is lacking owing to the paucity of culture-positive cases. Furthermore, prelicensure PCV13 efficacy against OM was not studied. METHODS: The study was conducted from October 2009 to July 2013. Case patients were children aged 5-35 months with OM (mostly complex OM [recurrent/nonresponsive, spontaneously draining, chronic with effusion]) from whom middle-ear fluid culture was obtained; controls were contemporary children with rotavirus-negative gastroenteritis in a prospective population-based rotavirus surveillance, from the same age group with similar ethnic distribution and geographic location. Vaccine effectiveness (VE) was estimated as 1 minus the odds ratio using unconditional logistic regression, adjusting for time since PCV implementation, age, and ethnicity. RESULTS: A total of 223 case patients and 1370 controls were studied. Serotypes 19F and 19A together caused 56.1% of all vaccine-type (VT) OM. VE of ≥2 PCV doses in children aged 5-35 months was demonstrated as follows: PCV7 against OM due to PCV7 serotypes, 57.2% (95% confidence interval, 6.0%-80.5%); PCV13 against OM due to PCV13 serotypes, 77.4% (53.3%-92.1%); PCV13 against OM due to the 6 additional non-PCV7 serotypes 67.4% (17.6%-87.1%); PCV13 against OM due to serotype 19F, 91.3% (1.4%-99.2%); and PCV13 against OM due to serotype 3, 85.2% (23.9%-98.4%). PCV7 and PCV13 VE against OM due to serotype 19A in children aged 12-35 months was 72.4% (95% confidence interval, 6.2%-91.9%) and 94.6% (33.9%-99.6%), respectively. CONCLUSIONS: PCV7 and PCV13 were effective against complex OM caused by the targeted serotypes. SN - 1537-6591 UR - https://www.unboundmedicine.com/medline/citation/33507250/Effectiveness_of_the_7__and_13_Valent_Pneumococcal_Conjugate_Vaccines_Against_Vaccine_Serotype_Otitis_Media_ L2 - https://academic.oup.com/cid/article-lookup/doi/10.1093/cid/ciab066 DB - PRIME DP - Unbound Medicine ER -