Nasopharyngeal carriage of otitis media pathogens in infants receiving 10-valent non-typeable Haemophilus influenzae protein D conjugate vaccine (PHiD-CV10), 13-valent pneumococcal conjugate vaccine (PCV13) or a mixed primary schedule of both vaccines: A randomised controlled trial

Aboriginal children in Northern Australia have a high burden of otitis media, driven by early and persistent nasopharyngeal carriage otopathogens, including non-typeable Haemophilus influenzae (NTHi) Streptococcus pneumoniae (Spn). In this context, does combined mixed primary series Synflorix Prevenar13 provide better protection against NTHi Spn serotypes 3, 6A 19A than either vaccine alone? infants (n = 425) were randomised to receive Synflorix™ (S, PHiD-CV10) or Prevenar13™ (P, PCV13) at 2, 4 6 months (_SSS _PPP, respectively), 4-dose PHiD-CV10 1, 2 PCV13 age (SSSP). Nasopharyngeal swabs collected 4, 7 age. Swabs ear discharge from tympanic membrane perforations. At the endpoint age, proportion (Np) positive for PCV13-only 6A, was 0%, 0.8%, 1.5% _SSS, SSSP groups respectively, 55%, 52%, 52% no statistically significant group differences other otopathogens any The most common (in order) 16F, 11A, 10A, 7B, 15A, 6C, 35B, 23B, 13, 15B, accounting 65% carriage. Ear 108) culture (52%), S. aureus (32%), pneumococcus (20%). experience colonisation perforations associated with NTHi, non-PCV13 pneumococcal first life. not significantly reduced compared standard _PPP _SSS schedules time point. Current conjugate formulations do offer onset high-risk population.