Disclosure belangen NHG spreker (Potentiële) belangenverstrengeling Voor bijeenkomst mogelijk relevante relaties met bedrijven Andere relatie, namelijk … I’m an employee and shareholder of Janssen Pharmaceuticals

Pneumococcal vaccination associated with fewer episodes of acute otitis media in Dutch children Alexandre Fortanier

Research questions What is the impact of PCV on AOM and its severity? Does age modify the effect?

Study population Primary care (ZGA and LRGP) health records Children born between 2004-2015 Only those registered at GP within 6 months Children prospectively followed until: censor date (age 5 years) end of registration at GP practice end of study period

Analysis and outcome measures Negative binomial model using GEE Primary care follow-up: offset variable Count = IRR; binary = RR Outcome measures Acute otitis media (ICPC H71) Recurrent AOM (rAOM) AOM treated with (topical) antibiotics AOM-related specialist referrals

Results Descriptives # Children 18,237 65,678 PY # AOM episodes 16,351 8,867 with (topical) antibiotics # Children with AOM 7,355 5,616 with (topical) antibiotics 1,200 with referral 711 with rAOM IRR (95% CI) post- versus pre-PCV Interaction with age AOM episodes 0.93 (0.86 to 1.00) No, P=0.24 RR (95% CI) post- versus pre-PCV Interaction with age rAOM 0.91 (0.72 to 1.14) AOM treated 0.97 (0.90 to 1.05) AOM with referral 1.15 (0.94 to 1.40)

Acknowledgements evidENT, University College London, United Kingdom Anne Schilder, MD, PhD Julius Center, University Medical Center Utrecht, the Netherlands Arno Hoes, MD, PhD Roger Damoiseaux, MD, PhD Roderick Venekamp, MD, PhD Marieke de Hoog, PhD Rebecca Stellato, MSc National Institute for Public Health and the Environment (RIVM) and UMC Utrecht, the Netherlands Lieke Sanders, MD, PhD