Pneumococcal vaccine for prevention of acute otitis media in children: a meta-analysis

Streptococcus pneumoniae-induced acute otitis media (AOM) continues to be a leading infectious disease among children, despite the introduction of pneumococcal conjugate vaccines (PCV). The effectiveness of pneumococcal vaccines in preventing AOM, as well as their impact on clinical manifestations and complications, remains a subject of debate. This meta-analysis aimed to assess the efficacy of pneumococcal vaccines, along with associated symptoms and complications. A comprehensive search was conducted across PubMed, Embase, Cochrane Library, and Web of Science for studies published between 2012 and 2024. The quality of the included studies was assessed using the Cochrane Risk of Bias tool, and statistical analysis was performed using StataMP18. The analysis included eleven studies encompassing 1,331,407 individuals. The results revealed that the experimental group exhibited a significant increase in the incidence of fever (≥ 38.5 °C) [RR = 1.370, 95% CI (1.272, 1.467), P < 0.001], as well as a significantly higher incidence of recurrent acute otitis media [RR = 1.053, 95% CI (1.040, 1.065), P < 0.001]. In conclusion, PCV may have limited efficacy in preventing AOM in certain pediatric subpopulations and settings, with substantial between-study heterogeneity.