Otitis Media Clinical Trial
Official title:
A Randomised Controlled Trial of Pneumococcal Conjugate Vaccines Synflorix and Prevenar13 in Sequence or Alone in High-risk Indigenous Infants (PREV-IX_COMBO): Immunogenicity, Carriage and Otitis Media Outcomes
The purpose of this study is to determine whether an early schedule of a combination of three doses of PHiD-CV and one dose of PCV13, is superior to three doses of either PCV13 or PHiD-CV.
Aboriginal children in the Northern Territory (NT) have high rates of otitis media caused by
non-capsular H. influenzae (NCHi) and pneumococci. Pneumococcal conjugate vaccine has
effectively reduced disease caused by the 7 serotypes. Rates of non-vaccine serotype otitis
media (OM), particularly 19A is increasing, and NCHi continues to be a major pathogen in
perforations. Parallels with pneumonia are highly probable in this population. Vaccines with
expanded and early age protection are needed.
In early 2009 GSK's pneumococcal H. influenzae protein D conjugate vaccine (PHiD-CV) was
licensed in Australia. Compared to the current vaccine, 7PCV, this vaccine offers protection
from pneumococcal serotypes 1, 5, 7F as well as NCHi (which is a primary pathogen of OM, and
possibly pneumonia). However by 2010, a new generation of Wyeth's 7PCV, PCV13 will also be
licensed in Australia. Compared to PHiD-CV this vaccine offers protection from additional
serotypes 3, 6A and 19A, however it does not offer protection from NCHi infection. There is
no empirical evidence to suggest that either vaccine will have superior clinical efficacy for
otitis media or pneumonia in high-risk children. The novel combination strategy proposed for
this trial has the potential to provide the best of both vaccines.
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