Prevalence of Pneumococcal and Hemophilus Influenza Type B Antibody Deficiency in Children With Persistent Ear, Nose, and Throat Infections

OBJECTIVE: The primary objective of this study is to determine the prevalence of Hib and Pneumococcal antibody deficiencies in pediatric patients with persistent or recurrent ENT infections, namely recurrent otitis media and recurrent sinusitis, following ear tube placement or adenoidectomy. STUDY DESIGN: This is an IRB approved, single institution, retrospective chart review using the electronic medical record at University of Mississippi Medical Center from January 2013 to December 2023. SETTING: University of Mississippi Medical Center, a tertiary referral hospital. METHODS: This study included 43 patients who had undergone either ear tube placement or adenoidectomy with a history of PCV and Hib titers data. Demographic data was obtained and complete vaccination records were confirmed. Prevalence of PCV and Hib titer deficiency was calculated, and statistical analysis was performed using Chi-square tests, Fischer exact test or independent t-test, depending on the variables. RESULTS: More than half (55%) of these patients were found to be indeterminate or have non-protective titers against Hemophilus influenzae type B, and 43% had titers considered non-protective against Pneumococcus. Given vaccination response rates are approximately 95% for the Hib vaccine and 97% to 100% for Prevnar vaccine, this demonstrates that children with recurrent ENT infections are approximately 11 times more likely to have indeterminate or non-protective titers to Hib and 14 times more likely to have non-protective titers to Pneumococcus. CONCLUSION: This study highlights the potential role of testing these titers in pediatric patients with recurrent ear and sinus infections despite surgical management, and sheds light on the potential role of booster vaccinations in this population.