title: Impact of pneumococcal conjugate vaccine on pediatric tympanostomy tube insertion in partial immunized population.
abstract: OBJECTIVE
  To investigate the impact of seven-valent pneumococcal conjugate vaccine on tube insertions in a partial immunized pediatric population.
  
  
  METHODS
  Retrospective ecological study.
  
  
  METHODS
  This study used Taiwan National Health Insurance Research Database for the period 2000-2009. Every child under 17 years old who received tubes during this 10-year period was identified and analyzed. The tube insertion rates in different age groups and the risk to receive tubes in different birth cohorts before and after the release of the vaccine in 2005 were compared.
  
  
  RESULTS
  The tube insertion rates for children under 17 years of age ranged from 21.6 to 31.9 for 100,000 persons/year. The tube insertion rate of children under 2 years old decreased significantly after 2005 in period effect analysis (β = -0.074, P < 0.05, and the negative β value means a downward trend) and increased in children 2 to 9 years old throughout the study period (positive β values which mean upward trends, P < 0.05). The rate of tube insertion was lower in 2004-2005 and 2006-2007 birth cohorts than that of 2002-2003 birth cohort (RR = 0.90 and 0.21, 95% CI 0.83-0.97 and 0.19-0.23, resp.).
  
  
  CONCLUSIONS
  The seven-valent pneumococcal conjugate vaccine may reduce the risk of tube insertion for children of later birth cohorts. The vaccine may have the protective effect on tube insertions in a partial immunized pediatric population.
authors.affiliation: Department of Otolaryngology Head and Neck Surgery, Taipei Veterans General Hospital, Taipei, Taiwan ; School of Medicine, National Yang-Ming University, Taipei, Taiwan ; Institute of Public Health and Community Medicine Research Center, National Yang-Ming University, Taipei, Taiwan.
authors.forename: Mao-Che
authors.initials: MC
authors.lastname: Wang
authors.affiliation: Institute of Public Health and Community Medicine Research Center, National Yang-Ming University, Taipei, Taiwan ; Department of Otolaryngology Head and Neck Surgery, Mackay Memorial Hospital, Taipei, Taiwan ; Department of Audiology and Speech Language Pathology and School of Medicine, Mackay Medical College, New Taipei City, Taiwan.
authors.forename: Ying-Piao
authors.initials: YP
authors.lastname: Wang
authors.affiliation: Department of Otolaryngology Head and Neck Surgery, Taipei Veterans General Hospital, Taipei, Taiwan ; School of Medicine, National Yang-Ming University, Taipei, Taiwan.
authors.forename: Chia-Huei
authors.initials: CH
authors.lastname: Chu
authors.affiliation: Department of Otolaryngology Head and Neck Surgery, Taipei Veterans General Hospital, Taipei, Taiwan ; School of Medicine, National Yang-Ming University, Taipei, Taiwan.
authors.forename: Tzong-Yang
authors.identifier: 0000-0001-7287-9956
authors.initials: TY
authors.lastname: Tu
authors.affiliation: Department of Otolaryngology Head and Neck Surgery, Taipei Veterans General Hospital, Taipei, Taiwan ; School of Medicine, National Yang-Ming University, Taipei, Taiwan.
authors.forename: An-Suey
authors.initials: AS
authors.lastname: Shiao
authors.affiliation: Institute of Public Health and Community Medicine Research Center, National Yang-Ming University, Taipei, Taiwan.
authors.forename: Pesus
authors.initials: P
authors.lastname: Chou
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D016208:Databases, Factual / Q000639:trends; D005260:Female; D000069443:Heptavalent Pneumococcal Conjugate Vaccine / Q000008:administration & dosage*; D006801:Humans; D007114:Immunization / Q000639:trends*; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008876:Middle Ear Ventilation / Q000639:trends*; D022242:Pneumococcal Vaccines / Q000008:administration & dosage; D011159:Population Surveillance / Q000379:methods; D012189:Retrospective Studies; D013624:Taiwan / Q000453:epidemiology; D018074:Vaccines, Conjugate / Q000008:administration & dosage
chemical_list: D000069443:Heptavalent Pneumococcal Conjugate Vaccine; D022242:Pneumococcal Vaccines; D018074:Vaccines, Conjugate
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