Impact of 13-valent Pneumococcal Conjugate Vaccine on Pneumococcal Nasopharyngeal Carriage in Children With Acute Otitis Media

Cohen, Robert MD*,†; Levy, Corinne MD*; Bingen, Edouard PhD; Koskas, Marc MD*; Nave, Isabelle MD§; Varon, Emmanuelle MD

Pediatric Infectious Disease Journal: March 2012 - Volume 31 - Issue 3 - p 297–301
doi: 10.1097/INF.0b013e318247ef84
Vaccine Reports

Background: 13-valent pneumococcal conjugate vaccine (PCV13) licensure was based on the immune response (enzyme-linked immunosorbent assay and opsonophagocytic assay) compared with PCV7. National surveillance program of pneumococcal nasopharyngeal (PNP) carriage in children with acute otitis media (AOM) was set up in 2001 when PCV7 was introduced in France and continues to the present. This program was used in 2010–2011 to assess the effect of the implementation of PCV13 on PNP carriage in young children with AOM.

Methods: Between October 2010 and March 2011, 58 pediatricians obtained 943 nasopharyngeal swabs from children (6 to 24 months of age) with AOM. The swabs were sent for analysis to the French National Reference Centre for Pneumococci. Demographics, medical history, and physical examination findings were recorded.

Results: Among 943 children enrolled (mean age, 13.4 months), 651 had received at least 1 dose of PCV13 and 285 received PCV7 only. Among PCV13-vaccinated children, overall PNP carriage and carriage of serotypes not in PCV7 were significantly lower as compared with children exclusively vaccinated with PCV7 (53.9% vs. 64.6%, P = 0.002 and 9.5% vs. 20.7%, P < 0.0001, respectively). For serotypes 19A, 7F, and 6C, the carriage rates were also significantly lower in PCV13-vaccinated patients than in patients only vaccinated by PCV7: 7.5% versus 15.4%, P < 0.001, 0.5% versus 2.8%, P = 0.002, and 3.7% versus 8.4%, P = 0.003, respectively.

Conclusion: In young children (<2 years) with AOM, this study suggests that PCV13 has an impact on overall PNP carriage, as well as on serotypes 19A, 7F, and 6C.

From the *ACTIV (Association Clinique et Thérapeutique Infantile du Val de Marne), Paris, France; †Département de Microbiologie, Centre Hospitalier Intercommunal de Créteil, Créteil, France; ‡Service de Microbiologie, Hôpital Robert-Debré (AP-HP), Université Denis-Diderot Paris 7, Paris, France; §AFPA (Association Française de Pédiatrie Ambulatoire), Selestat, France; and ¶HEGP (Hôpital Européen Georges Pompidou), (AP-HP) Centre National de Référence des Pneumocoques, Université Paris 5, Paris, France.

Accepted for publication December 22, 2011.

Supported by Pfizer Pharmaceuticals France. The authors have no other funding or conflicts of interest to disclose.

Address for correspondence: Robert Cohen, MD, ACTIV, 27 rue Inkermann, F94100 Saint Maur des Fossés, France. E-mail:,

© 2012 by Lippincott Williams & Wilkins, Inc.