• Medientyp: E-Artikel
  • Titel: Increase in tympanostomy tube placements despite pneumococcal vaccination, a population‐based study
  • Beteiligte: Eythorsson, Elias; Sigurdsson, Samuel; Erlendsdóttir, Helga; Hrafnkelsson, Birgir; Kristinsson, Karl G.; Haraldsson, Ásgeir
  • Erschienen: Wiley, 2019
  • Erschienen in: Acta Paediatrica, 108 (2019) 8, Seite 1527-1534
  • Sprache: Englisch
  • DOI: 10.1111/apa.14724
  • ISSN: 1651-2227; 0803-5253
  • Schlagwörter: General Medicine ; Pediatrics, Perinatology and Child Health
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  • Beschreibung: <jats:title>Abstract</jats:title><jats:sec><jats:title>Aim</jats:title><jats:p>The aim was to estimate the impact of the 10‐valent pneumococcal vaccine (<jats:styled-content style="fixed-case">PH</jats:styled-content>iD‐<jats:styled-content style="fixed-case">CV</jats:styled-content>) on tympanostomy tube placements (<jats:styled-content style="fixed-case">TTP</jats:styled-content>) in children under five years of age in Iceland.</jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p>This population‐based observational cohort study followed 11 consecutive birth‐cohorts 2005–2015 from birth until their fifth birthday. Population registries were merged using national identification numbers. The risk of <jats:styled-content style="fixed-case">TTP</jats:styled-content> was compared between birth‐cohorts adjusted for the number of previous otitis media diagnoses and antimicrobial prescriptions. A Cox regression model was applied and the hazard ratio (<jats:styled-content style="fixed-case">HR</jats:styled-content>) of <jats:styled-content style="fixed-case">TTP</jats:styled-content> was estimated between each birth‐cohort and the last vaccine non‐eligible birth‐cohort. The vaccine impact of <jats:styled-content style="fixed-case">PH</jats:styled-content>iD‐<jats:styled-content style="fixed-case">CV</jats:styled-content>10 on <jats:styled-content style="fixed-case">TTP</jats:styled-content> was estimated as 1‐<jats:styled-content style="fixed-case">HR</jats:styled-content> ×100%.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>In total, 51 247 children were followed for 210 724 person‐years, of which 14 351 underwent 20 373 procedures. The estimated vaccine impact on <jats:styled-content style="fixed-case">TTP</jats:styled-content> was −6% (95% <jats:styled-content style="fixed-case">CI</jats:styled-content> −16% to 2.7%). Children in the vaccine‐eligible cohorts had fewer previous otitis media diagnoses and had been prescribed fewer antimicrobials prior to the procedure than children in the vaccine non‐eligible cohorts.</jats:p></jats:sec><jats:sec><jats:title>Conclusion</jats:title><jats:p>Despite high uptake of <jats:styled-content style="fixed-case">PH</jats:styled-content>iD‐<jats:styled-content style="fixed-case">CV</jats:styled-content>10, tympanostomy procedures increased in Iceland during the study period. Vaccine‐eligible children had milder disease prior to the procedure. The reason underlying these findings are speculative.</jats:p></jats:sec>