{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,22]],"date-time":"2025-10-22T03:05:54Z","timestamp":1761102354393,"version":"3.40.5"},"reference-count":29,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2019,2,17]],"date-time":"2019-02-17T00:00:00Z","timestamp":1550361600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/100004330","name":"GlaxoSmithKline","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100004330","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Paediatrica"],"published-print":{"date-parts":[[2019,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aim<\/jats:title><jats:p>The aim was to estimate the impact of the 10\u2010valent pneumococcal vaccine (<jats:styled-content style=\"fixed-case\">PH<\/jats:styled-content>iD\u2010<jats:styled-content style=\"fixed-case\">CV<\/jats:styled-content>) on tympanostomy tube placements (<jats:styled-content style=\"fixed-case\">TTP<\/jats:styled-content>) in children under five years of age in Iceland.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This population\u2010based observational cohort study followed 11 consecutive birth\u2010cohorts 2005\u20132015 from birth until their fifth birthday. Population registries were merged using national identification numbers. The risk of <jats:styled-content style=\"fixed-case\">TTP<\/jats:styled-content> was compared between birth\u2010cohorts adjusted for the number of previous otitis media diagnoses and antimicrobial prescriptions. A Cox regression model was applied and the hazard ratio (<jats:styled-content style=\"fixed-case\">HR<\/jats:styled-content>) of <jats:styled-content style=\"fixed-case\">TTP<\/jats:styled-content> was estimated between each birth\u2010cohort and the last vaccine non\u2010eligible birth\u2010cohort. The vaccine impact of <jats:styled-content style=\"fixed-case\">PH<\/jats:styled-content>iD\u2010<jats:styled-content style=\"fixed-case\">CV<\/jats:styled-content>10 on <jats:styled-content style=\"fixed-case\">TTP<\/jats:styled-content> was estimated as 1\u2010<jats:styled-content style=\"fixed-case\">HR<\/jats:styled-content> \u00d7100%.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In total, 51\u00a0247 children were followed for 210\u00a0724 person\u2010years, of which 14\u00a0351 underwent 20\u00a0373 procedures. The estimated vaccine impact on <jats:styled-content style=\"fixed-case\">TTP<\/jats:styled-content> was \u22126% (95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> \u221216% to 2.7%). Children in the vaccine\u2010eligible cohorts had fewer previous otitis media diagnoses and had been prescribed fewer antimicrobials prior to the procedure than children in the vaccine non\u2010eligible cohorts.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Despite high uptake of <jats:styled-content style=\"fixed-case\">PH<\/jats:styled-content>iD\u2010<jats:styled-content style=\"fixed-case\">CV<\/jats:styled-content>10, tympanostomy procedures increased in Iceland during the study period. Vaccine\u2010eligible children had milder disease prior to the procedure. The reason underlying these findings are speculative.<\/jats:p><\/jats:sec>","DOI":"10.1111\/apa.14724","type":"journal-article","created":{"date-parts":[[2019,1,23]],"date-time":"2019-01-23T23:40:46Z","timestamp":1548286846000},"page":"1527-1534","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Increase in tympanostomy tube placements despite pneumococcal vaccination, a population\u2010based study"],"prefix":"10.1111","volume":"108","author":[{"given":"Elias","family":"Eythorsson","sequence":"first","affiliation":[{"name":"Faculty of Medicine University of Iceland Reykjavik Iceland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Samuel","family":"Sigurdsson","sequence":"additional","affiliation":[{"name":"Faculty of Medicine University of Iceland Reykjavik Iceland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Helga","family":"Erlendsd\u00f3ttir","sequence":"additional","affiliation":[{"name":"Faculty of Medicine University of Iceland Reykjavik Iceland"},{"name":"Department of Clinical Microbiology Landsp\u00edtali University Hospital Reykjavik Iceland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Birgir","family":"Hrafnkelsson","sequence":"additional","affiliation":[{"name":"Department of Mathematics University of Iceland Reykjavik Iceland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Karl G.","family":"Kristinsson","sequence":"additional","affiliation":[{"name":"Faculty of Medicine University of Iceland Reykjavik Iceland"},{"name":"Department of Clinical Microbiology Landsp\u00edtali University Hospital Reykjavik Iceland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5364-7877","authenticated-orcid":false,"given":"\u00c1sgeir","family":"Haraldsson","sequence":"additional","affiliation":[{"name":"Faculty of Medicine University of Iceland Reykjavik Iceland"},{"name":"Children's Hospital Iceland Landsp\u00edtali University Hospital Reykjavik Iceland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2019,2,17]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.286.17.2128"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0165657"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1177\/0194599812468849"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1542\/pir.26-2-61"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1177\/0194599811409862"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(15)00549-6"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1097\/00006454-200003000-00003"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijporl.2003.08.001"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1097\/INF.0000000000000857"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciy233"},{"key":"e_1_2_11_12_1","doi-asserted-by":"crossref","first-page":"350","DOI":"10.1007\/978-1-4757-3294-8","volume-title":"Modeling Survival Data: extending the Cox Model","author":"Therneau TM","year":"2000"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1097\/INF.0000000000000899"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12879-018-3416-y"},{"key":"e_1_2_11_15_1","doi-asserted-by":"crossref","first-page":"361","DOI":"10.1097\/INF.0000000000001870","article-title":"Decreased AOM with treatment failure following introduction of the ten\u2010valent pneumococcal haemophilus influenzae protein D conjugate vaccine","volume":"37","author":"Eythorsson E","year":"2017","journal-title":"Pediatr Infect Dis J"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2006-2138"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.1097\/INF.0b013e31819e9bc5"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2014-007151"},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.1097\/00006454-200212000-00005"},{"key":"e_1_2_11_20_1","doi-asserted-by":"publisher","DOI":"10.1080\/02813430510031298"},{"key":"e_1_2_11_21_1","doi-asserted-by":"publisher","DOI":"10.1001\/archotol.132.11.1216"},{"key":"e_1_2_11_22_1","doi-asserted-by":"publisher","DOI":"10.1097\/00006454-200204000-00018"},{"key":"e_1_2_11_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijporl.2014.06.034"},{"key":"e_1_2_11_24_1","doi-asserted-by":"publisher","DOI":"10.1177\/000348940211101115"},{"key":"e_1_2_11_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijporl.2012.04.013"},{"key":"e_1_2_11_26_1","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.90.2.245"},{"key":"e_1_2_11_27_1","unstructured":"Eurostat.Employment statistics [Internet].2017[cited 2017 Sep 23]. 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