PCV7, PCV13 vaccines effective against ear infection in young children
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Real-world data demonstrated that two pneumococcal conjugate vaccines, PCV7 and PCV13, protected against complex ear infection in young children, according to study results published in Clinical Infectious Diseases.
“Our study provides a unique opportunity for assessing real-life serotype-specific direct effectiveness of PCV7 and PCV13 against otitis media (OM) in young children,” Ron Dagan, MD, professor of pediatrics and infectious diseases at the Ben-Gurion University of the Negev in Beer-Sheva, Israel, and colleagues wrote.
“While the results with PCV7 are in line with prelicensure efficacy study, no efficacy data are available for PCV13 against OM,” they wrote. “The results provide insight into the level of direct protection afforded by these PCVs post implementation.”
Dagan and colleagues examined vaccine effectiveness of the PCV7 and PCV13 vaccines against various serotypes of OM. They recruited a total of 1,593 children aged 5 to 35 months old, 223 of whom had OM and 1,370 of whom were part of a control group. The researchers conducted their study between October 2009 and July 2013.
They found that OM serotypes 19F and 19A were responsible for 56.1% of all vaccine-serotype OM. PCV7 showed an efficacy of 57.2% against serotype VT7-OM, whereas PCV13 had an efficacy of 77.4%, 67.4%, and 91.3% against serotypes VT13-OM, the six additional non-VT7 serotypes and 19F-OM, respectively. The PCV13 vaccine also showed 91.3% and 85.2% efficacy against the 19F-OM and 3-OM serotypes, respectively.
“For multiple analyses, the case numbers were relatively small, resulting in wide confidence intervals, often making it difficult to draw conclusions for several subgroups,” the researchers wrote. “Nevertheless, this large study adds very valuable information to the limitations.”
Perspective
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This study assessed the real-world effectiveness of conjugate pneumococcal vaccines (PCV7 and/or PCV13) against pneumococcal OM. The investigators found that the vaccines were approximately 60% to 75% effective in preventing “complex” OM (ie, OM that was recurrent was not responsive to antimicrobial treatment that spontaneously drained pus or that was chronic with an effusion) due to types in the vaccines. These estimates are after adjustment for differences between cases with pneumococcal OM and controls. This study is useful because it is the first to directly assess the effectiveness of PCVs against vaccine-type OM with concurrent controls. One limitation of the study is that children with uncomplicated acute OM were not included. It would be difficult to include such children because tympanocentesis, which would be necessary for the child to undergo to be able to recover a causative organism from culture, is not indicated routinely for these children. It is also likely that these results could be generalized to the larger population of children with uncomplicated acute OM. The study simply documents the effectiveness of the vaccine and is consistent with the changing epidemiology of acute OM.
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