TY - JOUR
T1 - Pneumococcal Conjugated Vaccines Decreased Acute Otitis Media Burden
T2 - A Population-Based Study in Israel
AU - Marom, Tal
AU - Tshori, Sagi
AU - Shefer, Galit
AU - Pitaro, Jacob
N1 - Funding Information:
We thank Ms Ronit Harris and Ms Shira Mingelgrin for the statistical analyses and for their help in reviewing the manuscript.
Publisher Copyright:
© 2021 Elsevier Inc.
PY - 2021/8/1
Y1 - 2021/8/1
N2 - Objective: To study time trends in all-cause acute otitis media (AOM) burden by calculating incidence rates of AOM episodes and recurrent acute otitis media (rAOM) cases in highly immunized pediatric population during the pre- and post-pneumococcal conjugated vaccine (PCV) years. Study design: In this population-based study, AOM episodes and rAOM cases were identified in Clalit Health Services–insured Israeli children aged 0-10 years between 2005 and 2018 by using a data-sharing platform. Because a near-sequential implementation of PCV-7/PCV-13 occurred within a 1-year period (2009/2010), we compared AOM visits before (2005-July 2009) and after (August 2009-2018) the introduction of PCVs. We focused on children younger than 2 years of age, who are the target population of PCVs and are at AOM peak age. Results: We identified 805 389 AOM episodes contributed by 270 137 children. The median number of AOM episodes was 2 (IQR 1-4). A downward trend of incidence rates of AOM episodes was observed during the post-PCV years in children younger than age 9 years (P < .001). The largest decrease (21%) was observed in children younger than 1 year, from 807/1000 children during the pre-PCV years to 640/1000 during the post-PCV years (P < .001). An average annual decrease of ∼14/1000 AOM episodes was calculated in children younger than 1 year old (β = −13.39, 95% CI –16.25 to −10.53, P < .001). Of rAOM cases, documented in 84 237 (31.2%) children, 74% were in children younger than 2 years, and 55% were in boys. The risk to develop rAOM significantly decreased during the post-PCV years in children younger than 2 years (hazard ratio 0.893, 95% CI 0.878-0.908; P < .001). Conclusions: AOM burden significantly decreased following PCVs introduction in highly immunized children.
AB - Objective: To study time trends in all-cause acute otitis media (AOM) burden by calculating incidence rates of AOM episodes and recurrent acute otitis media (rAOM) cases in highly immunized pediatric population during the pre- and post-pneumococcal conjugated vaccine (PCV) years. Study design: In this population-based study, AOM episodes and rAOM cases were identified in Clalit Health Services–insured Israeli children aged 0-10 years between 2005 and 2018 by using a data-sharing platform. Because a near-sequential implementation of PCV-7/PCV-13 occurred within a 1-year period (2009/2010), we compared AOM visits before (2005-July 2009) and after (August 2009-2018) the introduction of PCVs. We focused on children younger than 2 years of age, who are the target population of PCVs and are at AOM peak age. Results: We identified 805 389 AOM episodes contributed by 270 137 children. The median number of AOM episodes was 2 (IQR 1-4). A downward trend of incidence rates of AOM episodes was observed during the post-PCV years in children younger than age 9 years (P < .001). The largest decrease (21%) was observed in children younger than 1 year, from 807/1000 children during the pre-PCV years to 640/1000 during the post-PCV years (P < .001). An average annual decrease of ∼14/1000 AOM episodes was calculated in children younger than 1 year old (β = −13.39, 95% CI –16.25 to −10.53, P < .001). Of rAOM cases, documented in 84 237 (31.2%) children, 74% were in children younger than 2 years, and 55% were in boys. The risk to develop rAOM significantly decreased during the post-PCV years in children younger than 2 years (hazard ratio 0.893, 95% CI 0.878-0.908; P < .001). Conclusions: AOM burden significantly decreased following PCVs introduction in highly immunized children.
KW - acute otitis media
KW - children
KW - intervention
KW - pneumococcal conjugated vaccine
KW - recurrent acute otitis media
UR - http://www.scopus.com/inward/record.url?scp=85105810648&partnerID=8YFLogxK
U2 - 10.1016/j.jpeds.2021.04.025
DO - 10.1016/j.jpeds.2021.04.025
M3 - Article
C2 - 33894263
AN - SCOPUS:85105810648
SN - 0022-3476
VL - 235
SP - 233-238.e3
JO - Journal of Pediatrics
JF - Journal of Pediatrics
ER -