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Increase in tympanostomy tube placements despite pneumococcal vaccination, a population-based study

Increase in tympanostomy tube placements despite pneumococcal vaccination, a population-based study

Title: Increase in tympanostomy tube placements despite pneumococcal vaccination, a population-based study
Author: Eyþórsson, Elías
Sigurdsson, Samuel   orcid.org/0000-0001-7517-6973
Erlendsdóttir, Helga
Hrafnkelsson, Birgir   orcid.org/0000-0003-1864-9652
Kristinsson, Karl G.
Haraldsson, Ásgeir
Date: 2019-01-22
Language: English
Scope: 1527-1534
University/Institute: Háskóli Íslands
University of Iceland
School: Heilbrigðisvísindasvið (HÍ)
School of Health Sciences (UI)
Verkfræði- og náttúruvísindasvið (HÍ)
School of Engineering and Natural Sciences (UI)
Department: Læknadeild (HÍ)
Faculty of Medicine (UI)
Raunvísindadeild (HÍ)
Faculty of Physical Sciences (UI)
Series: Acta Paediatrica;108(8)
ISSN: 0803-5253
DOI: 10.1111/apa.14724
Subject: Conjugate vaccines; Middle ear ventilation; Otitis media; PHiD-CV vaccine; Streptococcus pneumoniae; Bóluefni; Bólusetningar; Pneumókokkar; Börn; Tilviksrannsóknir
URI: https://hdl.handle.net/20.500.11815/1671

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Eythorsson, Elias, Sigurdsson, Samuel, Erlendsdóttir, Helga, Hrafnkelsson, Birgir, Kristinsson, Karl G, & Haraldsson, Ásgeir. (2019). Increase in Tympanostomy Tube Placements despite Pneumococcal Vaccination, a Population-based Study., 30667099.


Aim: The aim was to estimate the impact of the 10-valent pneumococcal vaccine (PHiD-CV) on tympanostomy tube placements (TTP) in children under five years of age in Iceland. Methods: 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 TTP 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 (HR) of TTP was estimated between each birth-cohort and the last vaccine non-eligible birth-cohort. The vaccine impact of PHiD-CV10 on TTP was estimated as 1-HR ×100%. Results: 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 TTP was −6% (95% CI −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. Conclusion: Despite high uptake of PHiD-CV10, 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.


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