Kiwi contribution to kid's ear infection knowledge

Monday, 21 May 2012

Dr Nikki Mills, Paediatric Otolaryngologist (kids ear, nose and throat specialist) is helping combat New Zealand children's middle ear infections with her latest research.

Dr Mills used advanced molecular techniques to identify and study the actual bacteria causing middle ear infections in New Zealand children. Instead of having to rely on old New Zealand information or Australian and European data when prescribing antibiotics doctors will be able to make desisions on 'real life' information. The research also considered the child's medical history, family history, exposure to cigarette smoke and exposure to overcrowding in the household as these have been linked to a higher risk of ear infections.

The results of Dr Mills' research will also contribute to understanding how the pneumococcal immunisation on the National Immunisation Schedule may be hepling to reduce ear infections. It could contribute to recommendations about future immunisations to include on the Schedule.

The pneumococcal vaccine, Synflorix®, is currently on the National Schedule to prevent pneumococcal pneumonia and invasive pneumococcal disease like blood infection and meningitis in children less than 5 years of age. However, there is some evidence that the vaccine reduces ear infections when they are caused by a type of the pneumococcal bacteria the vaccine protects against.

The study involved more than 460 children in three New Zealand District Health Boards – Auckland, Counties Manukau and Canterbury – with Dr Emma Best (Starship Children’s Hospital) and Dr Tony Walls (Christchurch Hospital) working as co-investigators alongside Dr Mills. With their parent's permission children having an operation for grommets, or another medical procedure, under general anaesthetic had swabs from the back of their nose and a sample of middle ear fluid (when they were having grommets inserted) to find out what bacteria were present.


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Synflorix® is used for primary and booster vaccination of infants and children up to their 5th birthday to protect against disease caused by 10 types of streptococcus pneumoniae.

What is the difference between Prevenar®, Synflorix® and Prevenar 13®?


From July 2011 a pneumococcal conjugate vaccine called Synflorix® replaced Prevenar® at the scheduled visits of 6 weeks, 3 months, 5 months and 15 months of age. Prevenar 13® replaced Prevenar® for children with particular medical conditions eligible for the High Risk Pneumococcal Immunisation Programme.

From July 2014 Prevenar 13® replaced Synflorix® and continued for children with particular medical conditions eligible for the High Risk Pneumococcal Immunisation Programme.

Synflorix® covered the same seven pneumococcal types that Prevenar® did plus three more types. Prevenar 13® covers the same 10 pneumococcal types that Synflorix® did plus three more types. The safety profile for all three vaccines is similar.

The body’s immune responses to both Synflorix® and Prevenar 13® are comparable to the responses to Prevenar® for the pneumococcal bacteria types they have in common. Therefore, both Synflorix® and Prevenar 13® are expected to be as least as effective as Prevenar® in preventing serious infections. However, until Synflorix® and Prevenar 13® have been used for many years, like Prevenar® has, there will be no data to show how much more effective they may be. The new vaccines also generate a protective response against additional pneumococcal types not covered by Prevenar®.

A child who has started their course of pneumococcal protection with Synflorix® can complete their course with Prevenar 13®. When this occurs the child is expected to develop full protection against the 10 types of pneumococcal bacteria in both vaccines. They may also develop partial protection for the extra three types in Prevenar 13®

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What is the difference between Prevenar®, Prevenar 13® or Synflorix® and Pneumovax® 23?


Prevenar®, Prevenar 13®, Synflorix® and Pneumovax® 23 are all vaccines against pneumococcal disease, a leading cause of serious illness in children and some adults, but there are differences in the way they are made.

Prevenar®, Prevenar 13® and Synflorix® are conjugate vaccines. The sugar molecules from the outside of the bacteria have been attached to a special protein to make them better at stimulating the immune system. Young infants respond well to this type of vaccine. Prevenar® offers protection against seven common types of pneumococcal bacteria, Synflorix® offers protection against 10 common types, and Prevenar 13® against 13 types of pneumococcal bacteria.

Pneumovax® 23 is a polysaccharide vaccine. It is made using the sugar molecules from the outside of the bacteria. It is not very effective in infants under two years of age as their immune systems are too immature to generate a strong, protective response to this kind of vaccine. Older children and adults do respond to Pneumovax® 23 but not as well as they do to the conjugate vaccines. The advantage of Pneumovax® 23 is that it protects against 23 types of pneumococcal bacteria.

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