28. Mai-01. Juni 2013: ESPID, Milano

Impact of pneumococcal conjugate vaccines on acute otitis media among children in Germany
Mathilda Diel1, Maren Laurenz1, Kathrin Krause1, Ralf Sprenger2, Andreas Busse3
1Pfizer Pharma GmbH, Berlin, 2CONVIDIA clinical research GmbH, Münster, 3Kinder- und Jugendarztpraxis, Tegernsee

Background: Routine infant immunization with the pneumococcal conjugate vaccine PCV7 started in Germany in 2007. Although substantial decline of invasive pneumococcal diseases has been observed, the effect of PCVs on non-invasive disease is unknown so far. Therefore, we assessed in these analyses the impact of PCVs on otitis media (OM) in children in Germany.

Methods: Data from IMS-Health-VIP® were used for uninterrupted time series analyses that used ICD-10 diagnosis rates as main outcomes (H66=suppurative OM, H65=non suppurative OM). The pre-vaccine period 2003-2006 provided baseline values and was compared to the single years 2007-2011 characterized by a rapidly growing vaccination rate with 7-valent and higher-valent PCVs in children <2 years of age. Percentaged reduction rates were adjusted to the size of the corresponding age cohorts; the Poisson model was used for statistical analysis.

Results: During baseline period an average of 1,403,497/391,828 episodes of suppurative/non-suppurative OM occurred annually in children aged 0-4 years. In 2011, the episodes had reduced significantly by 19.3%/25,9% (p-value for both <0.0001) for suppurative/non-suppurative OM representing a reduction of 270,875/101,483 cases in 2011 compared to baseline. During the 5 years from 2007 to 2011 the cumulated numbers of reduced episodes were 833,677/346,483 for suppurative/non-suppurative OM. Analysis among children aged 5-10 years showed similar trends.

Conclusion: A significant reduction in otitis media diagnoses among children in Germany after introduction of PCVs was demonstrated. Our results contribute to the growing body of evidence supporting the beneficial impact of pneumococcal conjugate vaccines in children also in non-invasive disease.

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