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Published on: February 23, 2014
Pneumococcal conjugate vaccines for preventing otitis media
Angelique G S C Jansen1, Eelko Hak, Reinier H Veenhoven
1Department of Pediatric Immunology and Infectious Diseases, University Medical Center Utrecht - Wilhelmina Children's Hospital, PO Box 85090, Utrecht, Netherlands, 3508 AB. a.g.s.c.jansen@umcutrecht.nl
The Cochrane Database of Systematic Reviews
|April 17, 2009
Summary
Pneumococcal conjugate vaccines (PCVs) show marginal benefits in preventing acute otitis media (AOM) in infants, with a 6-7% risk reduction. PCVs administered to older children with a history of AOM do not prevent further episodes.
Area of Science:
- Pediatrics
- Immunology
- Infectious Diseases
Background:
- Acute otitis media (AOM) is a prevalent childhood illness.
- Antibiotic resistance and high costs necessitate alternative prevention strategies like vaccines.
- Pneumococcal conjugate vaccines (PCVs) are being investigated for AOM prevention.
Purpose of the Study:
- To evaluate the efficacy of PCVs in preventing AOM in children up to 12 years old.
- To synthesize evidence from randomized controlled trials on PCV effectiveness for AOM.
- To assess the impact of different PCV formulations and administration timings.
Main Methods:
- Systematic search of CENTRAL, MEDLINE, and EMBASE databases (1995-2007).
- Inclusion of randomized controlled trials (RCTs) of PCVs in children aged 12 or younger with ≥6 months follow-up.
- Independent data extraction and quality assessment by multiple reviewers.
Main Results:
- Seven trials involving 7- to 11-valent PCVs were analyzed.
- The licensed 7-valent PCV (CRM197-PCV7) showed a 6-7% relative risk reduction in AOM episodes when given in infancy.
- An 11-valent PCV demonstrated a 34% risk reduction, while a 9-valent PCV showed a 17% reduction in specific contexts.
- PCV7 administered to older children with prior AOM history offered no additional benefit.
Conclusions:
- Infant-administered 7-valent PCV provides marginal but potentially significant public health benefits for AOM prevention.
- Different PCV formulations and carrier proteins exhibit varying efficacy.
- PCV administration in older children with a history of AOM is not recommended for preventing recurrent episodes.
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