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The Impact of Pneumococcal Conjugate Vaccine on Rates of Myringotomy With Ventilation Tube Insertion in Australia

Jardine, Andrew; Menzies, Robert I.; Deeks, Shelley L; Patel, Mahomed; McIntyre, Peter

Description

Background: In randomized controlled trials and postmarketing studies the heptavalent pneumococcal conjugate vaccine (7vPCV) has been shown to reduce myringotomy with ventilation tube insertion (MVTI) procedures in a 4-dose schedule. In Australia, a 3-dose schedule at 2, 4, and 6 months of age is routinely used in non-Indigenous children. Our aim was to determine if a reduction in MVTI comparable to that documented in the United States occurred in Australia despite the absence of the booster...[Show more]

dc.contributor.authorJardine, Andrew
dc.contributor.authorMenzies, Robert I.
dc.contributor.authorDeeks, Shelley L
dc.contributor.authorPatel, Mahomed
dc.contributor.authorMcIntyre, Peter
dc.date.accessioned2015-12-10T22:54:45Z
dc.identifier.issn0891-3668
dc.identifier.urihttp://hdl.handle.net/1885/59788
dc.description.abstractBackground: In randomized controlled trials and postmarketing studies the heptavalent pneumococcal conjugate vaccine (7vPCV) has been shown to reduce myringotomy with ventilation tube insertion (MVTI) procedures in a 4-dose schedule. In Australia, a 3-dose schedule at 2, 4, and 6 months of age is routinely used in non-Indigenous children. Our aim was to determine if a reduction in MVTI comparable to that documented in the United States occurred in Australia despite the absence of the booster dose. Methods: All episodes of MVTI in Australia from July 1998 to June 2007 among children aged ≤9 years were identified in an electronic database of national hospitalization records, including the public and private sectors. Age-stratified rates of MVTI before and after introduction of 7vPCV into the national immunization program in 2005 were determined, with Poisson regression modeling used to determine the vaccine impact after adjusting for background and seasonal trends. Results: A total of 238,634 hospital separations were identified. In the 2.5 years after routine 7vPCV introduction, there was a significant adjusted reduction in MVTI in children aged <1, 1, and 2 years of 23%, 16%, and 6%, respectively. A nonsignificant reduction was observed in those aged 3 and 4 years, while a significant increase of 5% was observed for the 5- to 9-year age group. Conclusions: Although ecologic data such as this have limitations, the significant differential effects observed by time period and age group are suggestive of a vaccine effect of similar magnitude to that documented by postmarketing surveillance in the United States. The rapid uptake of 7vPCV in Australia, including catch up to 2 years of age, is an important difference to the United States and it is possible that an even greater effect would have been observed with a booster dose in the second year of life. Longer term data will be needed to fully assess the role of a booster dose.
dc.publisherLippincott Williams & Wilkins
dc.sourceThe Pediatric Infectious Disease Journal
dc.subjectKeywords: Pneumococcus vaccine; article; Australia; child; chronic otitis media; drug dose regimen; electronic medical record; herd immunity; human; infection prevention; infection rate; major clinical study; middle ear ventilation; myringotomy; Poisson distributio Heptavalent pneumococcal conjugate vaccine; Immunization schedule; Middle ear ventilation; Otitis media
dc.titleThe Impact of Pneumococcal Conjugate Vaccine on Rates of Myringotomy With Ventilation Tube Insertion in Australia
dc.typeJournal article
local.description.notesImported from ARIES
local.identifier.citationvolume28
dc.date.issued2009
local.identifier.absfor060502 - Infectious Agents
local.identifier.ariespublicationu4105084xPUB508
local.type.statusPublished Version
local.contributor.affiliationJardine, Andrew, College of Medicine, Biology and Environment, ANU
local.contributor.affiliationMenzies, Robert I., University of Sydney & Westmead Hospital
local.contributor.affiliationDeeks, Shelley L, University of Sydney
local.contributor.affiliationPatel, Mahomed, College of Medicine, Biology and Environment, ANU
local.contributor.affiliationMcIntyre, Peter, University of Sydney
local.description.embargo2037-12-31
local.bibliographicCitation.issue9
local.bibliographicCitation.startpage761
local.bibliographicCitation.lastpage765
local.identifier.doi10.1097/INF.0b013e31819e9bc5
dc.date.updated2016-02-24T10:36:01Z
local.identifier.scopusID2-s2.0-68549107895
local.identifier.thomsonID000269407500001
CollectionsANU Research Publications

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