Efficacy of Pneumococcal Vaccine on Otitis Media: A Systematic Review and Meta‐Analysis

• Published in: Otolaryngology-head and neck surgery Vol. 169; no. 4; pp. 765 - 779
• Main Authors: Wannarong, Thanakrit, Ekpatanaparnich, Pichamon, Boonyasiri, Adhiratha, Supapueng, Orawan, Vathanophas, Vannipa, Tanphaichitr, Archwin, Ungkanont, Kitirat
• Format: Journal Article
• Language: English
• Published: England 01-10-2023
• Subjects: otitis media; pneumococcal vaccine; tympanic membrane perforation; tympanostomy tube insertion; tympanostomy tube insertion; tympanic membrane perforation; otitis media; pneumococcal vaccine
• ISSN: 0194-5998; 1097-6817
• DOI: 10.1002/ohn.327

Objective
To assess the effect of the pneumococcal vaccine (PCV) toward the surgical management and complications of otitis media.
Data Sources
MEDLINE, EMBASE, PubMed, Scopus, and clinicaltrial.gov.
Review Methods
A systematic search was performed using a combination of keywords and standardized terms about PCV and surgical management or complications of otitis media. Following Preferred Reporting Items for Systematic Reviews and Meta‐Analyses guidelines, studies were screened by 3 independent reviewers. Risk of bias assessment, followed by meta‐analysis in only randomized‐controlled trials was conducted. Vaccine efficacy (VE) and 95% confidence interval (CI) were reported.
Results
Of the 2649 s reviewed, 27 studies were included in the qualitative analysis and were categorized into 6 outcomes: tympanostomy tube insertion, otitis media with effusion (OME), mastoiditis, spontaneous tympanic membrane (TM) perforation, recurrent acute otitis media (AOM), and severe AOM. Fifteen studies were included in the meta‐analysis to evaluate the rate of tympanostomy tube insertion, OME, and recurrent AOM. PCV was significantly more effective in lowering the rate of tympanostomy tube insertion (VE, 22.2%; 95% CI, 14.6‐29.8) and recurrent AOM (VE, 10.06%; 95% CI, 7.46‐12.65) when compared with the control group, with no significant difference in reducing the incidence of OME. The qualitative analysis revealed that PCV had efficacy in preventing severe AOM and spontaneous TM perforation but the effect on mastoiditis remained unclear.
Conclusion
The PCV was effective in reducing the rate of tympanostomy tube insertion and the incidence of recurrent AOM with a nonsignificant effect in preventing OME in children.