Ear Infections - Prevention

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In general, experts recommend that the flu vaccine be given to all children over 6 months with a condition that requires regular medical care. Children who are susceptible to recurrent ear infections should probably be given vaccinations against influenza viruses. In fact, in 2003 the American Academy of Pediatrics (AAP) and the CDC encourages vaccination in all children, including healthy children, between 6 months and 2 years of age. This recommendation may vary from year to year depending on the supply of the vaccine.

Possible negative side effects include the following:

• Allergic Reaction. Newer vaccines contain very little egg protein, but an allergic reaction still may occur in people with strong allergies to eggs.
• Soreness at the Injection Site. Up to two-thirds of people who receive the influenza vaccine develop redness or soreness at the injection site for 1 or 2 days afterward.
• Flu-like Symptoms. Other side effects include mild fatigue and muscle aches and pains. They tend to occur between 6 and 12 hours after the vaccination and last up to 2 days. These symptoms are not influenza itself but an immune response to the virus proteins in the vaccine. Anyone with a fever, however, should not be vaccinated until the ailment has subsided.

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Antiviral Drugs. Antiviral drugs have now been developed to treat influenza. One such drug, oseltamivir (Tamiflu), is approved for use in children age 1 year and older. Studies report significant reduction in symptoms and in the incidence of ear infections with this drug. In another study, when the antiviral drug, zanamivir (Relenza), was administered in the nasal passages of adults with influenza, middle ear abnormalities were reduced from 73 - 32%. This drug is available for children older than 7 years for treatment of influenza, but no research has determined it value for preventing or treating otitis media in children.

Preventing Bacterial Infections

Preventive Antibiotics. Antibiotics have been used to prevent bacterial infections in children with recurrent ear infections (4 or more episodes a year). Studies suggest, however, that overall they only prevent 1 episode a year, and are not generally recommended for prevention, except for specific situations.

Pneumococcal Vaccine. The pneumococcal vaccine protects (Prevnar or PCV7) against S. pneumoniae (also called pneumococcal) bacteria, the most common cause of middle ear infections and other respiratory infections. It has now been added to the Recommended Childhood Immunization Schedule and is also specifically approved for preventing otitis media. An important 2003 study indicated that these vaccinations could result in 1.7 million fewer office visits, 24% fewer procedures for tube implants, and significantly fewer antibiotic prescriptions.