title: Long-term effect of pneumococcal conjugate vaccines on tympanostomy tube placements.
abstract: BACKGROUND
  We have previously shown that the 7-valent pneumococcal conjugate vaccine (PncCRM) given in infancy is effective in reducing tympanostomy tube placements up to 4 to 5 years of age. This study aimed to assess the effectiveness of pneumococcal conjugate vaccines PncCRM and PncOMPC from 2 up to 13 years of age.
  
  
  METHODS
  Altogether 2497 children participated in the Finnish Otitis Media Vaccine trial conducted in 1995 to 1999 and were vaccinated at 2, 4, 6 and 12 months of age with PncCRM or PncOMPC or hepatitis B vaccine as controls. The data for tympanostomy tube placements were collected from health registers including hospital and private office operations. Vaccine efficacy was estimated by comparing incidences of tympanostomies from 2 to 12-13 years of age in each of the pneumococcal vaccine groups with the control group.
  
  
  RESULTS
  Register data were searched for 2474 subjects. A total of 535 tympanostomy tube placements were identified in the health registers from 1998 through 2008 with a cumulative incidence of 14.6% from 2 to 13 years of age in the control group. The vaccine impact was age-dependent: from 2 through 5 years of age the vaccine effectiveness was 34% (95% confidence interval: 1% to 52%) for PncCRM and 6% (-28 to 31) for the PncOMPC vaccine. For the age group of 6 to 12-13 years the vaccine effectiveness estimates for the PncCRM and PncOMPC groups were -13% (-137 to 46) and -2% (-123 to 54), respectively.
  
  
  CONCLUSIONS
  PncCRM vaccine reduced the tympanostomy tube placements up to 5 years of age. No impact on new surgical procedures could be demonstrated after that but the benefit achieved was sustained.
authors.affiliation: Department of Vaccination and Immune Protection, National Institute for Health and Welfare, Tampere, Finland.
authors.forename: Ilona
authors.initials: I
authors.lastname: Sarasoja
authors.forename: Jukka
authors.initials: J
authors.lastname: Jokinen
authors.forename: Mika
authors.initials: M
authors.lastname: Lahdenkari
authors.forename: Terhi
authors.initials: T
authors.lastname: Kilpi
authors.forename: Arto A
authors.initials: AA
authors.lastname: Palmu
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D004311:Double-Blind Method; D005500:Follow-Up Studies; D000069443:Heptavalent Pneumococcal Conjugate Vaccine; D006801:Humans; D022401:Meningococcal Vaccines / Q000008:administration & dosage* / Q000276:immunology; D008876:Middle Ear Ventilation / Q000379:methods*; D010033:Otitis Media / Q000517:prevention & control / Q000628:therapy*; D011008:Pneumococcal Infections / Q000517:prevention & control; D022242:Pneumococcal Vaccines / Q000008:administration & dosage* / Q000276:immunology; D016016:Proportional Hazards Models
chemical_list: D000069443:Heptavalent Pneumococcal Conjugate Vaccine; D022401:Meningococcal Vaccines; C096336:PncOMPC vaccine; D022242:Pneumococcal Vaccines