 We previously reported the efficacy of a pneumococcal non-typeable hemophilus influenzae, NTI, protein deconjugate vaccine, P-high DCV, in a double-blind randomized trial against various diseases, including acute otitis media, AOM. In this study, we provide further analyses of the Panamanian subset of the trial. In the Panamanian subset, 7,359 children were randomly assigned to receive P-high DCV or a control vaccine at age 2, 4, 6 and 15 to 18 months. Of these, 2,000 had nasopharyngeal swabs collected. AOM cases were captured when parents sought medical attention for children with symptoms of AOM, and surveillance was enhanced approximately two years into the study through regular telephone calls or home visits by study personnel. The mean follow-up was 31.4 months. Clinical AOM, COM, cases were assessed by physicians and confirmed by otorhinolaryngologists. Middle ear fluid samples, taken from children with COM after specific informed consent, and nasopharyngeal samples were cultured for pathogen identification. For the 7,359 children, 2,574 suspected AOM cases were assessed by. This article was authored by Xavier César Lorenz, Stella Rowley, Dick Nguyen and others. We are article.tv, links in the description below.