{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,5]],"date-time":"2026-01-05T22:17:05Z","timestamp":1767651425036,"version":"build-2065373602"},"reference-count":17,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2014,11,10]],"date-time":"2014-11-10T00:00:00Z","timestamp":1415577600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["aao-hnsfjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Otolaryngol.--head neck surg."],"published-print":{"date-parts":[[2015,2]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>To discuss pediatric head and neck complications of pneumococcal infections before and after the introduction of the PCV7 vaccine.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design<\/jats:title><jats:p>Cross\u2010sectional analysis of a national database.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Setting<\/jats:title><jats:p>Kids National Inpatient Database.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A retrospective review of the Kids National Inpatient Database yielded 31,738 pediatric reports involving complications of meningitis, mastoiditis, periorbital cellulitis, and Bezold abscesses due to <jats:italic>Streptococcus pneumoniae<\/jats:italic> diagnoses. Each report was analyzed for incidence, length of stay, mean hospital cost, and inpatient admittance from the emergency department. Finally, we calculated the expected annual incidence of each complication via variance\u2010weighted analysis to determine the expected incidence if the vaccine was not administered.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We identified a significant decrease in the incidence of several complications after the introduction of the PCV7 vaccine and also when comparing these findings to our predicted incidence calculations if the vaccine was not administered. Inpatient admittance from the emergency department for Bezold abscess, periorbital cellulitis, mastoiditis, and meningitis was significantly increased in the pediatric age group (ages 1\u20104; <jats:italic>P<\/jats:italic> &lt;. 05). Furthermore, there was a significant increase in the cost to provide care for each of the described conditions (<jats:italic>P<\/jats:italic> &lt;. 05).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The PCV7 vaccine produced a measurable reduction in head and neck complications associated with <jats:italic>S pneumoniae<\/jats:italic>. However, our data suggest that these benefits were also met with increased inpatient admittance from the emergency department, hospital costs, and length of stay, each of which may be attributed to the selection of a more pathogenic subtype.<\/jats:p><\/jats:sec>","DOI":"10.1177\/0194599814557777","type":"journal-article","created":{"date-parts":[[2014,11,11]],"date-time":"2014-11-11T00:33:49Z","timestamp":1415666029000},"page":"336-341","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["Pediatric Head and Neck Complications of <i>Streptococcus pneumoniae<\/i> before and after PCV7 Vaccination"],"prefix":"10.1002","volume":"152","author":[{"given":"Andrew","family":"Walls","sequence":"first","affiliation":[{"name":"Georgetown University School of Medicine Washington, DC"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matthew","family":"Pierce","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head &amp; Neck Surgery Georgetown University Hospital Washington, DC"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nathan","family":"Krishnan","sequence":"additional","affiliation":[{"name":"Georgetown University School of Medicine Washington, DC"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matthew","family":"Steehler","sequence":"additional","affiliation":[{"name":"Ear, Nose, &amp; Throat Associates of Corpus Christi Otolaryngology\u2013Head and Neck Surgery Corpus Christi Texas"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"suffix":"Jr","given":"Earl H.","family":"Harley","sequence":"additional","affiliation":[{"name":"Georgetown University School of Medicine Washington, DC"},{"name":"Department of Otolaryngology\u2013Head &amp; Neck Surgery and Pediatrics Georgetown University Hospital Washington, DC"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2014,11,10]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.106.2.362"},{"key":"e_1_2_8_3_1","first-page":"1","article-title":"Prevention of pneumococcal disease among infants and children: use of 13\u2010valent pneumococcal conjugate vaccine and 23\u2010valent pneumococcal polysaccharide vaccine","volume":"59","author":"Centers for Disease Control and Prevention","year":"2010","journal-title":"Recommendations and Reports"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.285.13.1729"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1086\/587897"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1128\/CMR.00009-08"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2007-2703"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.106.5.e61"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1469-0691.2009.02726.x"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.01201-12"},{"key":"e_1_2_8_11_1","unstructured":"United States Agency for Healthcare Research and Quality.Nationwide Inpatient Sample Redesign Final Report.April 4 2011.https:\/\/www.hcup\u2010us.ahrq.gov\/db\/nation\/nis\/reports\/NISRedesignFinalReport040914.pdf.Accessed December 18 2013."},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1001\/archpediatrics.2011.1501"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2013-1747"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1086\/648593"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.2174\/138161207779313731"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1592\/phco.31.4.408"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1093\/jac\/45.1.5"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.3390\/vaccines2010112"}],"container-title":["Otolaryngology\u2013Head and Neck Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1177\/0194599814557777","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1177\/0194599814557777","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/aao-hnsfjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1177\/0194599814557777","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,20]],"date-time":"2025-10-20T11:39:19Z","timestamp":1760960359000},"score":1,"resource":{"primary":{"URL":"https:\/\/aao-hnsfjournals.onlinelibrary.wiley.com\/doi\/10.1177\/0194599814557777"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2014,11,10]]},"references-count":17,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2015,2]]}},"alternative-id":["10.1177\/0194599814557777"],"URL":"https:\/\/doi.org\/10.1177\/0194599814557777","archive":["Portico"],"relation":{},"ISSN":["0194-5998","1097-6817"],"issn-type":[{"type":"print","value":"0194-5998"},{"type":"electronic","value":"1097-6817"}],"subject":[],"published":{"date-parts":[[2014,11,10]]},"assertion":[{"value":"2014-07-21","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2014-10-10","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2014-11-10","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}