title: Panel 6: Vaccines.
abstract: OBJECTIVE
  To update progress on the effectiveness of vaccine for prevention of acute otitis media (AOM) and identification of promising candidate antigens against Streptococcus pneumoniae, nontypeable Haemophilus influenzae, and Moraxella catarrhalis.
  
  
  METHODS
  Literature searches were performed in OvidSP and PubMed restricted to articles published between June 2007 and September 2011. Search terms included otitis media, vaccines, vaccine antigens, and each of the otitis pathogens and candidate antigens identified in the ninth conference report.
  
  
  CONCLUSIONS
  The current report provides further evidence for the effectiveness of pneumococcal conjugate vaccines (PCVs) in the prevention of otitis media. Observational studies demonstrate a greater decline in AOM episodes than reported in clinical efficacy trials. Unmet challenges include extending protection to additional serotypes and additional pathogens, the need to prevent early episodes, the development of correlates of protection for protein antigens, and the need to define where an otitis media vaccine strategy fits with priorities for child health.
  
  
  CONCLUSIONS
  Acute otitis media continues to be a burden on children and families, especially those who suffer from frequent recurrences. The 7-valent PCV (PCV7) has reduced the burden of disease as well as shifted the pneumococcal serotypes and the distribution of otopathogens currently reported in children with AOM. Antibiotic resistance remains an ongoing challenge. Multiple candidate antigens have demonstrated the necessary requirements of conservation, surface exposure, immunogenicity, and protection in animal models. Further research on the role of each antigen in pathogenesis, in the development of correlates of protection in animal models, and in new adjuvants to elicit responses in the youngest infants is likely to be productive and permit more antigens to move into human clinical trials.
authors.affiliation: Boston University School of Medicine, Boston, Massachusetts, USA. spelton@bu.edu
authors.forename: Stephen I
authors.initials: SI
authors.lastname: Pelton
authors.forename: Melinda M
authors.initials: MM
authors.lastname: Pettigrew
authors.forename: Stephen J
authors.initials: SJ
authors.lastname: Barenkamp
authors.forename: Fabrice
authors.initials: F
authors.lastname: Godfroid
authors.forename: Carlos G
authors.initials: CG
authors.lastname: Grijalva
authors.forename: Amanda
authors.initials: A
authors.lastname: Leach
authors.forename: Janak
authors.initials: J
authors.lastname: Patel
authors.forename: Timothy F
authors.initials: TF
authors.lastname: Murphy
authors.forename: Sanja
authors.initials: S
authors.lastname: Selak
authors.forename: Lauren O
authors.initials: LO
authors.lastname: Bakaletz
mesh_terms: D001428:Bacterial Vaccines / Q000008:administration & dosage; D019317:Evidence-Based Medicine; D006193:Haemophilus influenzae / Q000302:isolation & purification; D006801:Humans; D001936:Moraxella catarrhalis / Q000302:isolation & purification; D010033:Otitis Media / Q000276:immunology / Q000382:microbiology / Q000517:prevention & control*; D022242:Pneumococcal Vaccines / Q000008:administration & dosage* / Q000276:immunology; D013296:Streptococcus pneumoniae / Q000302:isolation & purification; D016896:Treatment Outcome; D018074:Vaccines, Conjugate / Q000008:administration & dosage
chemical_list: D001428:Bacterial Vaccines; D022242:Pneumococcal Vaccines; D018074:Vaccines, Conjugate
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