Vaccine Reduces Ear Infections, Need for Ear Tubes

April 02, 2007

Szilagyi

Children have fewer frequent ear infections and fewer children need ear tubes since the introduction of the pneumococcal conjugate vaccine in 2000.

Acute otitis media – ear infection -- is the most common infection for which antibacterial agents are prescribed for children in the United States, according to the American Academy of Pediatrics, and it’s a very common reason for visiting the doctor (16 million visits in 2000).

 “Since we began giving children the pneumococcal conjugate vaccine, we’ve seen a steady decline in the rate of ear infections. For example, in our very large sample from Monroe County, we saw a 28 percent decline in frequent ear infections and a 23 percent decline in ear tubes,” said Peter Szilagyi, M.D., M.P.H., chief of General Pediatrics at the University of Rochester’s Golisano Children’s Hospital at Strong, and an author of a study on the subject in this month’s Pediatrics.

The pneumococcal conjugate vaccine (Prevnar, which had its start in basic research two decades ago at the University at what is now Golisano Children’s Hospital at Strong) was designed to protect against Streptococcus pneumoniae bacteria, which can cause serious illness and death. Invasive pneumococcal disease is responsible for about 200 deaths each year among children under 5 years old and is the leading cause of bacterial meningitis in the United States, according to the Centers for Disease Control and Prevention. The bacteria is also estimated to cause about 5 million ear infections every year. The CDC said that pneumococcal infections can be hard to treat because the bacteria have become resistant to some of the drugs that have been used to treat them.

The study analyzed healthcare utilization during the first 5 years of life for 150,000 children in Tennessee and 26,000 children in the Rochester area who were born between 1998 and 2002, which encompassed the period before and after widespread implementation of the pneumococcal conjugate vaccine. This is the first known study to evaluate the development of frequent ear infections and ear tube procedures in specific populations since the pneumococcal conjugate vaccine was introduced.

The declines in frequent ear infections and ear tube insertions exceeded the results in randomized, controlled trials of the vaccine prior to its introduction to the general population. This suggests that there may even be indirect benefits for children who were not fully vaccinated, perhaps due to herd immunity, Szilagyi said. Herd immunity occurs when a large enough percentage of the population is vaccinated against specific viruses or bacteria so that those who aren’t vaccinated are less likely to be exposed to those viruses or bacteria.

 “While the major health benefit of this vaccine is to prevent many cases of meningitis and pneumonia, it is wonderful to see that the vaccine seems to have a significant effect in reducing ear infections as well.” Szilagyi said.

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