Among developed and developing countries, acute otitis media is a major

public health problem.1 AOM has been considered a significant public health
problem in the Philippines. A study by Caro, et al (2014), that estimated the
prevalence of clinically diagnosed acute otitis media among children 12 years old
and below, found that an overall prevalence of clinically diagnosed acute otitis
media in the Philippines is at 9.6%, with no gender predilection, varying among the
different areas surveyed. It was found that 0-2 age group have the most prevalent
cases of AOM.1

Multiple pneumococcal conjugate vaccines have been developed, with PCV7

being the pioneer, which with the following serotypes: 4, 6B, 9V, 14, 18C, 19F, and
23F. This was followed by the production of PCV 10, a decavalent pneumococcal
vaccine with additional serotypes 1, 5 7F, have been described by several studies to
have been able to induce antibody responses against all pneumococcal serotypes in
the vaccine. The latest developed PCV13 contains polysaccharides of the capsular
antigens of Streptococcus pneumoniae serotypes 1, 3, 4, 5, 6A, 6B, 7F, 9V, 14, 18C,
19A, 19F, and 23F, individually conjugated to a nontoxic diphtheria CRM197 (CRM,
cross- reactive material) carrier protein. 5

In various studies, there are numerous (>90) serotypes of S pneumoniae that

have been found to colonize the oropharynx and the extent to which the seven (or
nine or 11 depending on the vaccine) serotypes contributed to the overall incidence
of AOM was small. It has also been found that there may have been subsequent
serotype replacement with other types that were equally responsible for AOM. More
recent studies have concluded that the use of the 13-valent PCV (PCV-13) has not
only decreased the incidence of AOM caused by vaccine-specific serotypes but has
also demonstrated a further decrease in penicillin-resistant pneumococcal isolates
in AOM ( 2-4).
There are multiple studies discussing the relationship of the use of these
vaccines and recurrence of otitis media wherein a significant decrease is seen in
both out patient visits and frequency of recurrence of OM.
Gwynz sent me PCV & studies 6 I didn’t include them 

1 Caro RM, Llanes EGDV, Ricalde RR, Sarol JN. Prevalence of Clinically Diagnosed
Acute Otitis Media (AOM) in the Philippines: a National Survey with a Developing
Country’s Perspective. Acta Medica Philippina. 2014;48(4):30-34.
http://actamedicaphilippina.com.ph/sites/default/files/fulltexts/48-4-2015-prevalence-
clinically.pdf. Accessed March 8, 2018.
2 Kaplan SL, Center KJ, Barson WJ, et al. Multicenter surveillance of Streptococcus
pneumoniae isolates frommiddle ear and mastoid cultures in the 13-valent
pneumococcal conjugate vaccine era. Clin Infect Dis 2015;60:1339-45.
3. Hau I, Levy C, Caeymaex L, Cohen R. Impact of pneumococcal conjugate vaccines
on microbial epidemiology andclinical outcomes of acute otitis media. Paediatric
Drugs [serial online]. February 2014;16(1):1-12. Available from:MEDLINE, Ipswich,
MA. Accessed March 1, 2018.
4 Ben-Shimol S, Givon-Lavi N, Leibovitz E, Raiz S, Greenberg D, Dagan R. Near-
elimination of otitis media caused by 13-valent pneumococcal conjugate vaccine (PCV)
serotypes in southern Israel shortly after sequential introduction of 7-valent/13-
valent PCV. Clin Infect Dis 2014;59:1724-32.
5 from Jazzzzz
6 From Gwynz: Reilly P, Jankowski TA. Does pneumococcal conjugate vaccine
prevent otitis media? Fontinos C, ed. The Journal of Family Practice. 2011;60(8):488-
489. http://www.jfponline.com .