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Ambulatory Care Visits with a Diagnosis of Otitis Media

[text version]

Ambulatory care visits include those made to physician offices, hospital outpatient departments, and emergency departments.

This graph shows data collected annually in the US. National Ambulatory Medical Care Survey (NAMCS) and National Hospital Ambulatory Medical Care Survey (NHAMCS) on the number of office visits with otitis media as the diagnosis for children under the age of 18 years. The overall rate shows a general decline from the baseline rate of 34.47 per 100 children in 1997 to a rate of 24.66 per 100 children in 2007. The steepest decline has occurred for young children under 3 years of age where the prevalence of ear infections (otitis media) is highest. Introduction of the pneumococcal conjugate vaccine, which was licensed for routine infant administration in 2000, may be responsible in part for this decline (Black et al., 2000; Fireman et al., 2003; Black et al., 2006; US. HHS, 2006). A study in the U.S. has shown a decline in otitis media diagnoses in vaccinated children. Comparing otitis media rates in 1994–99 with 2002–03 among children <2 years, a significant 20% decline (246 otitis media visits per 1,000 children per year) was observed (Grijalva et al., 2006).

Source: HP 2010 Data. Chart created by the Epidemiology and Statistics Program, NIDCD, NIH. Updated in November 2012.


  • Black S, Shinefield H, Fireman B, Lewis E, Ray P, Hansen J, Elvin L, Ensor KM, Hackell J, Siber G, Malinoski F, Madore D, Chang IH, Kohberger R, Watson W, Austrian R, Edwards K, The Northern California Kaiser Permanente Vaccine Study Center Group. Efficacy, safety and immunogenicity of heptavalent pneumococcal conjugate vaccine in children. Pediatr Infect Dis J. 2000; 19: 187–195.
  • Fireman B, Black SB, Shinefield HR, Lee J, Lewis E, Ray P. Impact of pneumococcal conjugate vaccine on otitis media. Pediatr Infect Dis J. 2003; 22: 10–16.
  • Black S, Shinefield H, Baxter R, Austrian R, Elvin L, Hansen J, Lewis E, Fireman B. Impact of the use of heptavalent pneumococcal conjugate vaccine on disease epidemiology in children and adults. Vaccine. 2006; 24 Suppl 2: 79–80.
  • Grijalva CG, Poehling KA, Nuorti JP, Zhu Y, Martin SW, Edwards KM, Griffin MR. National Impact of Universal Childhood Immunization With Pneumococcal Conjugate Vaccine on Outpatient Medical Care Visits in the United States. Pediatrics. 2006; 118: 865–73.
  • U.S. Department of Health and Human Services. Chapter 28: Vision and Hearing. In: Healthy People 2010 Midcourse Review. Washington, DC: U.S. Government Printing Office, December 2006; 28–5.
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