Do pneumococcal conjugate vaccine (PCV13 or PCV10) and Haemophilus influenzae type b vaccine (Hib) prevent acute otitis media in children?

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Last updated: September 29, 2026 • View editorial policy

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Yes, vaccines do help prevent ear infections in children.

Pneumococcal conjugate vaccines (PCV13 and PCV10) and influenza vaccines provide meaningful protection against acute otitis media (AOM), while Haemophilus influenzae type b (Hib) vaccine primarily prevents invasive disease rather than ear infections.

Pneumococcal Conjugate Vaccines

The evidence strongly supports pneumococcal vaccination for AOM prevention. According to the 2013 AAP guidelines, pneumococcal conjugate vaccines have proven effective in preventing OM caused by pneumococcal serotypes contained in the vaccines 1. The data show:

  • 29% reduction in AOM caused by all pneumococcal serotypes among children who received PCV7 before 24 months of age 1
  • 6-7% overall reduction in all-cause AOM in clinical trials, though observational studies show medical office visits for otitis were reduced by up to 40% after PCV7 introduction 1
  • PCV13 demonstrated 86% effectiveness (95% CI: 61-94%) against AOM caused by the six additional serotypes not in PCV7, with a 91% reduction specifically for serotype 19A 2

The guidelines note that while the overall benefit for all-cause AOM appears modest in trials, the real-world impact has been substantial, likely due to herd immunity effects 1. Both PCV10 and PCV13 show consistent reductions in complicated OM, tympanostomy tube placement, and OM-related hospitalizations 3.

Important caveat: Serotype replacement may reduce long-term efficacy, and neither PCV13 nor PCV10 is effective against serotype 3 4. Additionally, non-typeable Haemophilus influenzae (NTHi) has emerged as the predominant pathogen in PCV-13 vaccinated children with severe AOM 5.

Influenza Vaccine

Influenza vaccination shows 30-55% efficacy in preventing AOM during respiratory illness season 1. This is clinically significant since up to two-thirds of young children with influenza develop AOM 1. Both trivalent inactivated influenza vaccine (TIV) and live-attenuated intranasal influenza vaccine (LAIV) demonstrate benefit, with pooled analysis suggesting LAIV may have higher efficacy 1.

Haemophilus influenzae Type b (Hib) Vaccine

The Hib vaccine is highly immunogenic and prevents invasive Haemophilus influenzae type b disease 6, but it does not protect against non-typeable H. influenzae (NTHi), which is a common cause of AOM. The 10-valent pneumococcal vaccine (PHiD-CV) conjugated with H. influenzae protein D showed no effect on NTHi carriage in clinical trials 7, and Hib vaccine itself is not indicated for AOM prevention.

Clinical Recommendations

Based on the AAP 2013 guidelines 1:

  • All children should receive the recommended pneumococcal conjugate vaccine series (currently PCV13 in the US, though PCV15 and PCV20 are now available)
  • Annual influenza vaccination is recommended for all children ≥6 months of age 1
  • Hib vaccine should be given per routine schedule for invasive disease prevention, not specifically for AOM prevention

The decline in OM incidence over the past decade is attributed to pneumococcal conjugate vaccination combined with judicious antibiotic use and accurate diagnosis 8. However, OM remains a leading cause for medical consultation and antibiotic prescription in high-income countries 8.

References

8
Guideline

otitis media.

Nature Reviews Disease Primers, 2016

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