From Our 2007 Archives

Pneumococcal Vaccine Helps Prevent Kids' Ear Infections

By Serena Gordon
HealthDay Reporter

MONDAY, April 2 (HealthDay News) -- While the primary reason for vaccinating children against pneumococcal disease is to guard them against serious diseases such as meningitis and pneumonia, an added benefit of the vaccine is that it cuts down on chronic ear infections and the need for ear-tube surgery.

Recent research suggests that when infants and young children receive the pneumococcal conjugate vaccine and the recommended booster shots, the incidence of frequent ear infections may decline by as much as 28 percent. The need for the surgical insertion of pressure-equalizing tubes in the ears went down by as much as 23 percent.

"The pneumococcal conjugate vaccine has been very successful in combating serious infections in children and is also giving benefits in terms of reducing ear infections and the need for tube surgery," said Dr. Katherine Poehling, a pediatrician at Brenner Children's Hospital at Wake Forest University Baptist Medical Center in Winston-Salem, N.C.

Results of the study are published in the April issue of Pediatrics. The research was conducted while Poehling was working at Vanderbilt University Medical Center in Nashville, Tenn.

Different strains of the bacterium Streptococcus pneumoniae are responsible for causing numerous serious illnesses, such as meningitis, some types of pneumonia and the blood infection, bacteremia. According to the U.S. Centers for Disease Control and Prevention (CDC), pneumococcal diseases are responsible for the deaths of about 200 children under the age of 5 in the United States each year.

S. pneumoniae is also a major cause of ear infections.

In 2000, a pneumococcal vaccine became commercially available for children under 2. Sold under the brand name, Prevnar, the pneumococcal conjugate vaccine was soon incorporated into the routine immunization schedule. It's recommended that infants receive four doses of the vaccine: at 2 months, 4 months, 6 months and the final shot at 12 to 15 months of age, according to the CDC.

For the current study, Poehling and her colleagues compared the risk of developing frequent ear infections or having ear-tube surgery for four different birth groups -- born in 1998-1999, 1999-2000, 2000-2001 and 2001-2002. Each group included about 37,000 babies from Tennessee and about 7,000 infants from upstate New York.

Less than 1 percent of the 1998-1999 group had received at least three doses of Prevnar. For the 2000-2001 group, that number was up to 75 percent.

When the researchers compared those same groups when the children were 2 years old, they found that the incidence of frequent ear infections declined by 17 percent in Tennessee children and by 28 percent in New York youngsters born in 2000-2001. The need for ear-tube surgery went down by 16 percent for Tennessee children and by 23 percent in New York kids.

In 2001-2002, the incidence of infections and the need for surgery remained the same in New York, but increased slightly in Tennessee. While the researchers aren't sure why that occurred, they suggested that further study was needed to ensure that new strains of the bacterium aren't developing.

The researchers also weren't sure why the New York group seemed to fare better than the Tennessee group. They theorize it may be due to differences in the populations. More of the New York children may have received the full vaccination schedule, according to the study. Other theories are that the Tennessee children may have spent more time in day care or had more exposure to passive smoke -- both known risk factors for developing ear infections.

The bottom line, however, is that "the proportion of children developing frequent ear infections and needing tubes decreased. Children prone to frequent infections are benefiting," said Poehling.

"This is a common organism that can cause really serious disease," said Dr. Nancy Young, head of the section of otology/neurotology in the division of pediatric otolaryngology at Children's Memorial Hospital in Chicago.

Young said pneumococcal meningitis used to be one of the most common reasons a child would lose hearing. "Since Prevnar, the number of children losing hearing from meningitis has declined dramatically. It's a very powerful vaccination."

"For parents, the reason to get this vaccine is to avoid the more invasive disease, but the reduced ear infections are a wonderful side benefit," said Young.

SOURCES: Katherine Poehling, M.D., pediatrician and associate professor, pediatrics, Brenner Children's Hospital, Wake Forest University Baptist Medical Center, Winston-Salem, N.C.; Nancy Young, M.D., head, section Otology/Neurotology, division of Pediatric Otolaryngology, Children's Memorial Hospital, and associate professor, Otolaryngology - Head and Neck Surgery, Feinberg School of Medicine, Northwestern University, Chicago; April 2007, Pediatrics

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