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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)
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.