Meningitis Vaccine Leads to Greater Reduction in Ear Infections

Studies have shown no serious reactions associated with this vaccine to date. Mild reactions can include:

• Redness, tenderness, or swelling at the administration site.
• Fever.
• Fussiness, drowsiness, or loss of appetite.

The Pediatrics Study

J. Pekka Nuorti, MD

A study published earlier this year in Pediatrics, which was funded in part by the Centers for Disease Control and Prevention’s New Vaccine Surveillance Network, was the first to document the long-term effects of the vaccine on otitis media.1 The objective of the study was to estimate the effect of routine childhood immunization with heptavalent pneumococcal conjugate vaccine on frequent otitis media (three episodes in six months or four episodes in one year) and pressure-equalizing tube (PET) insertions.

The study included all children enrolled at birth in TennCare, Tennessee’s managed care program that includes the Medicaid population and other low-income children, and all children enrolled at birth in three selected commercial insurance managed care organizations in upstate New York. The study population included children born between February 1998 and May 2003. The participants were broken into four birth cohorts: those born between July 1 and June 30, 1998-1999, 1999-2000, 2000-2001, and 2001-2002. The participants were followed until they reached five years of age.

Katherine Poehling, MD

Frequency of otitis media decreased progressively for all birth cohorts in the New York group, with percentages of decrease ranging from 16% to 30%. Decline in PET insertion in the New York participants ranged from 13% to 23%.

The Tennessee group showed a 16% to 17% decrease in otitis media through the 2000-2001 cohort, and then reflected an increase in the 2001-2002 group. However, the frequency of otitis media in 2001-2002 cohort remained lower than the 1998-1999 group. The results reflected a 3% decrease in frequency of otitis media in the Tennessee group over the life of the study. After showing a 12% to 16% decrease in earlier cohorts, the number of PET procedures in the 2001-2002 cohort in Tennessee was comparable to that of the 1998-1999 group.

Katherine Poehling, MD, Associate Professor of Pediatrics at Brenner Children’s Hospital at Wake Forest University in Winston-Salem, NC, primary author of the study, pointed out that the two groups included in the study were intensely different populations. She stated, In New York private insurance, we saw a progressive increase in benefit. In Tennessee, we saw a different pattern. Initially, there was a progressive increase, and then in the last year it went back nearly to baseline. What that means is unclear at this time.