Efficacy of pneumococcal conjugate vaccine against PCR-positive acute otitis media

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Arto A Palmu1, Annika Saukkoriipi, Jukka Jokinen

  • 1National Institute for Health and Welfare, Helsinki, Finland; Tampere School of Public Health, Tampere, Finland. arto.palmu@thl.fi

Vaccine
|January 27, 2009
PubMed

Insights

The pneumococcal conjugate vaccine (PncCRM) showed limited efficacy against acute otitis media (AOM) caused by pneumococcus. PncCRM was 19% effective against Ply-PCR-positive AOM, but not effective when culture-positive cases were excluded.

Area of Science:

  • Pediatrics
  • Vaccinology
  • Infectious Diseases

Background:

  • Acute otitis media (AOM) is a common childhood infection, frequently caused by Streptococcus pneumoniae.
  • Pneumococcal conjugate vaccines (PCVs) aim to prevent pneumococcal infections, including AOM.
  • Accurate etiological diagnosis of AOM is crucial for assessing vaccine efficacy.

Purpose of the Study:

  • To evaluate the efficacy of the PncCRM vaccine against acute otitis media (AOM) specifically when pneumococcal etiology is suggested by pneumolysin PCR (Ply-PCR).

Main Methods:

  • A randomized controlled trial involving 1662 infants was conducted.
  • Infants received either the PncCRM vaccine or a control vaccine.
  • Participants were monitored for AOM up to 24 months of age, with middle ear fluid samples collected for etiological analysis.

Main Results:

  • The PncCRM vaccine demonstrated a 19% efficacy against Ply-PCR-positive AOM.
  • When only culture-positive AOM cases were considered, the vaccine efficacy dropped to 3%.
  • These findings suggest limited impact of PncCRM on AOM where pneumococcal presence is indicated solely by Ply-PCR.

Conclusions:

  • The PncCRM vaccine shows a modest protective effect against AOM cases suggested to be pneumococcal by Ply-PCR.
  • The vaccine's efficacy is significantly diminished when relying solely on culture-confirmed pneumococcal AOM.
  • Current data do not strongly support the effectiveness of PncCRM in preventing AOM where pneumococcal etiology is only indicated by Ply-PCR.

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