Johns Hopkins Bloomberg School of Public Health
Center for American Indian Health

Presenter of 1 Presentation

O082 - IMPACT OF PCV ON DRAINING OTITIS MEDIA AMONG NATIVE AMERICAN CHILDREN UNDER 5 YEARS OF AGE LIVING ON NAVAJO AND WHITE MOUNTAIN APACHE TRIBAL LANDS (ID 456)

Session Type
Parallel Session
Date
Wed, 22.06.2022
Session Time
15:05 - 16:35
Room
Grand Ballroom East
Lecture Time
15:40 - 15:50

Abstract

Background

Native American children living on the Navajo and White Mountain Apache (WMA) tribal lands experience a high burden of otitis media (OM). We assessed the impact of pneumococcal conjugate vaccines (PCV7 introduced in 2000; PCV13 in 2010) on draining OM.

Methods

Through laboratory-based surveillance we identified pneumococci grown from OM specimens from Navajo and WMA children under 5 years of age. Pneumococci were serotyped. Culturing middle ear fluid was done at the provider’s discretion and practices varied over time, so yearly change in the odds of vaccine-type pneumococcal OM was assessed separately for PCV7-type (2000-2009) and PCV13-type (2010-2019) using a generalized linear model with a logit link and overdispersion parameter. PCV7-types were 4, 6B, 9V, 14, 18C, 19F, and 23F. PCV13-types were 1, 3, 5, 6A, 7F, 19A and PCV7-types.

Results

308 cases of pneumococcal OM were identified from 2000-2019 (Figure); serotypes were available from 236 (77%). The odds of vaccine-type OM declined yearly during the PCV7 period (OR=0.56, 95% CI: 0.29-0.81); however, a similar trend was not observed during the PCV13 period (OR=0.99, 95% CI: 0.86–1.15). During 2010-2019, serotypes 3, 19A, and 19F accounted for 96% of PCV13-type cases and 42% of all cases. Eighty percent of children with PCV13-type OM were fully vaccinated for age.

Conclusions

Use of PCV7 in this population was associated with a decline in the proportion of OM caused by PCV7-type; however, vaccine-type OM (predominantly 3, 19A, and 19F) persisted in the PCV13 era. Most vaccine-type cases occurred in PCV-vaccinated children.

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