Retrospectacle: A Neuroscience Blog

This vaccine wasn’t meant to prevent ear infections per se, but has had the welcome side effect of doing just that (for more on ear infections, go here). Pharmaceutical company Wyeth developed the vaccine PCV7 (marketed in the US under Prevnar) to ward off common bacterial infections, and has been around since 2000. However, children who received the vaccine had significantly less ear infections and a lower incidence of “tubes in the ears.” (For more on ear tubes, go here.)

The vaccination, given initially at 2, 4 and 6 months of age, was designed to combat a number of pneumococcal infections, including ear infections that most children have at least once by the time they turn 2 years old.

But Poehling said the new research shows that the vaccine also was preventing repeat infections, which occur three or four times a year in up to nearly a third of all children, often requiring the insertion of ear tubes to equalize pressure.

The vaccine also has helped adults, she said, by preventing the general spread of disease.

The study was published in the current issue of Pediatrics, and examined data from more than 150,000 children in Tennessee and another 26,409 in upstate New York. Below is a graph which follows the number of infections per year (tracked in NY), starting in 1998/1999. The vaccine was introduced in 2000, which represents a fall in the number of infections and a gradual continual decline until the end of data collection (2003).

i-995c1054491cf24a64e57752aeb74774-oto graph.bmp

Poehling et al. 2007. Reduction of Frequent Otitis Media and Pressure-Equalizing Tube Insertions in Children After Introduction of Pneumococcal Conjugate Vaccine. PEDIATRICS Vol. 119 No. 4, pp. 707-715.

Comments

  1. #1 Dan R.
    April 4, 2007

    As an adult who still gets 1-2 ear infections a year, who has 4 sets of tubes, (and who did not receive the vaccine as a child) this is going to be first thing I ask my doctor about the next time I see them.

  2. #2 Matt Weidman, M.D.
    April 15, 2007

    I believe Wyeth is working on a protein conjugate vaccine with expanded coverage against more pneumococcal subtypes. That’s good, because while we’re seeing fewer serious pneumococcal infections (meningitis, bacteremia / sepsis) and otitis media, some of the Strep pneumoniae subtypes not covered by the PCV7 vaccine are becoming more prevalent. Some of these subtypes seem to have a predilection for causing empyema, a serious and difficult to treat extra-pulmonary infection.

    Prevnar (PCV7) isn’t indicated for adults … or anyone over the age of five, for that matter. Adults with certain high risk conditions and anyone over 65 should receive Pneumovax, the 23-valent pneumococcal polysaccharide vaccine (PPV). Children under 2 years don’t respond well to polysaccharide vaccines, but adults should.

    Dan,
    I can only speculate about your situation, but I doubt vaccination will help. Strep pneumoniae only causes a fraction of ear infections (although they tend to be the more serious cases), and most adults have adequate immunity to the common subtypes even without vaccination. Haemophilus influenzae subtypes cause most ear infections now.

    I would suggest that there might be an anatomic or immunologic problem underlying your recurrent infection, but I can only speculate.