Impact of the Seven-Valent Pneumococcal Conjugate Vaccine on Pediatric Tympanostomy Tubes Insertions in Taiwan

Abstract

Objectives:

Seven-valent pneumococcal conjugate vaccine (PCV7) has been proved to be very effective on preventing invasive pneumococcal disease (IPD) and pneumonia in children and having indirect effect on unvaccinated age groups. Previous studies also showed that PCV7 vaccination decreased the incidence of otitis media and tympanostomy tubes (TT) insertions in vaccinated children. However the indirect effect of PCV7 on TT insertions has seldom been mentioned. PCV7 was released in Taiwan in 2005. It is only for high risk group and in the private market. Partial vaccination makes Taiwan a perfect model to study the indirect effect. We tried to examine the indirect effect of PCV7 on TT insertions in a population based setting.

Methods:

This retrospective study used the National Health Insurance databank for the period 2000 to 2009 in Taiwan. Every child under 18 years old who received TT in this 10-year period was identified and analyzed. The TT insertion rates in different age groups before and after the year 2005 were compared.

Results:

The TT insertion rate of children under 2 years old decreased significantly and increased in children 2 to 9 years after the year 2005. There is no obvious change in TT insertions for children older than 9 years old through the study period.

Conclusions:

The PCV7 may reduce TT insertion rate for children under 2 years old in Taiwan. This effect may be the direct effect or both direct and indirect effect of the vaccine. There was no indirect effect of PCV7 on TT insertions in children older than 2 years old.