Cochrane: Middle
ear infection or inflammation are broad terms to refer to acute otitis
media. It is one of the most common infectious diseases in infants and
preschool children, with 86% having an episode by the time they turn one
year old. Symptoms of an ear infection include ear pain and fever, but
it may cause hearing loss due to ear drum perforation or fluid
accumulation in the middle ear. Ear infections are usually bacterial in
origin and is commonly triggered by a viral infection. Antibiotics are
often used in treatment but they carry their own side effects and the
risk of antibiotic resistance. Influenza vaccines, more commonly
referred to as flu shots, are approved for infants after six months.
They prevent viral infections, thus may prevent the onset of an ear
infection.
A team of Cochrane authors, based in Malaysia and working with the Acute Respiratory Infections Group,
set out to study the effect of the flu shot in preventing middle ear
infections in infants and children. Included in their study were 10
randomised controlled trials involving 16,707 children aged six months
to six years. Nine out of the 10 studies were funded by vaccine
manufacturers. The overall quality of the evidence was high to moderate.
The primary outcomes
showed a small reduction in at least one episode of middle ear
inflection over at least six months of follow up (between 2 and 7%).
There was also a reduction in the use of antibiotics in vaccinated
children (between 0% and 30%). It remained uncertain whether it reduced
visits to the healthcare facilities or hospital admissions. No major
adverse events were reported.
“With
the flu shot, we saw a small reduction in middle ear infections and a
reduction in the use of antibiotics” said Norhayati M Noor, a researcher
in Universiti Sains Malaysia, Kelantan, Malaysia, and the lead author
of the Cochrane Review. “Given the small reduction and the current
practice of avoiding the overuse of antibiotics, promoting the flu shot
solely to reduce middle ear infections does not seem justified but the
results may be useful to parents when making a decision to vaccinate
their children. We recommend that future studies on flu vaccines will
include ear infections as an outcome and provide detailed safety data.”