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Otitis-prone children may fail to develop protective antibody levels
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Children who are stringently defined otitis prone may fail to achieve protective antibody concentrations after several routine vaccinations, according to recent study findings published in The Pediatric Infectious Disease Journal.
“The [stringently-defined otitis prone] child experienced recurrent ear infections despite newly defined, strictly applied and accurate diagnosis of every [acute otitis media], tympanocentesis drainage of [middle ear fluid] to remove pus, bacterial burden and pro-inflammatory cytokines from the middle ear space and individualized antibiotic treatment to optimize medical management,” researchers wrote. “A child with recurrent AOM should be considered a possible low vaccine responder and vaccine-induced antibody levels may need to be evaluated.”
Michael E. Pichichero
The study included 140 sera collected from children aged 6 to 24 months. Thirty-four stringently defined otitis-prone children and 34 healthy non-otitis prone children were evaluated for immunoglobulin G concentrations to diphtheria toxoid, tetanus toxoid, pertussis toxoid, filamentous hemagglutinin, pertactin, polio, hepatitis B, Haemophilus influenzae type b capsule and Streptococcus pneumoniae capsular polysaccharide conjugate vaccine.
Researchers found that a high percentage of stringently defined otitis-prone participants had non-protective antibody values persisting until aged 24 months despite routine boosters.
Some IgG protective titers were decreased in stringently defined otitis-prone participants, including diphtheria toxoid (P=.006); tetanus toxoid (P<.0001); pertussis toxoid (P<.0001); filamentous hemagglutinin (P=.001); pertactin (P=.005); hepatitis B (P<.0001); polio 3 (P=.03) and S. pneumoniae (P=.01). However, they were not decreased in polio 1,2, Hib capsule or S. pneumoniae 6B and 14.
“We have much more to learn about [stringently defined otitis-prone] children, but our results indicate this population may be vulnerable to some vaccine-preventable infections, particularly as their limited vaccine-induced memory wanes,” researchers wrote.
Disclosure: The study was funded in part by NIH and the Thrasher Research Fund.
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