Use of Vaccines to Prevent Meningitis in Persons with Cochlear Implants
Children with cochlear implants are more likely to get bacterial meningitis than children without cochlear implants. In addition, some children who are candidates for cochlear implants have anatomic factors which may increase their risk for meningitis.
Because children with cochlear implants are at increased risk for meningitis, CDC recommends that children with cochlear implants follow recommendations for pneumococcal vaccinations that also apply to other groups at increased risk.
Recommendations for the timing and type of pneumococcal vaccination vary with age and vaccination history and should be discussed with a healthcare provider.
Pneumococcal vaccination recommendations for people with cochlear implants include the following:
Children who have cochlear implants or are candidates for cochlear implants who have not received any previous doses of a pneumococcal conjugate vaccine (PCV7 or PCV13), should receive PCV13 as it is recommended routinely for all infants and children. In addition to receiving PCV13, children with cochlear implants should receive one dose of the pneumococcal polysaccharide vaccine (PPSV23) at age 2 years or older after completing all recommended doses of PCV13.
Children with cochlear implants who have already completed the 4-dose PCV7 series and have not received PCV13 or PPSV23 should receive one dose of PCV13. PCV13 should be followed ≥ 8 weeks later by a dose of PPSV23.
Children with cochlear implants aged 24 through 71 months:
who have not received any doses of PCV7 or PCV13 previously should receive 2 doses of PCV13;
who have received an incomplete schedule of <3 doses of PCV (PCV7 or PCV13) before age 24 months should receive 2 doses of PCV13; or
who have received 3 doses of PCV (PCV7 or PCV13) should receive a single dose of PCV13.
Children 6 through 18 years of age with cochlear implants should receive a single dose of PCV13 regardless of whether they have previously received PCV7 or PPSV23. PCV13 should be followed ≥ 8 weeks later by a dose of PPSV23. Children aged 6 through 18 years with cochlear implants who have not received PCV13 and who previously received ≥ 1 doses of PPSV23 should be given a single dose of PCV13 ≥ 8 weeks after the last PPSV23 dose, even if they have received PCV7.
- The vaccines available in the United State that protect against most of the bacteria that cause meningitis are:
- 13-valent pneumococcal conjugate (PCV-13) (Prevnar 13®)
- 23-valent pneumococcal polysaccharide (PPSV23) (Pneumovax®)
- Haemophilus influenzae type b conjugate (Hib)
- Bivalent (C, Y) meningococcal and Haemophilus influenzae type b conjugate (MenHibrix®)
- Quadrivalent (A, C, W, Y) meningococcal conjugate (Menactra® and Menveo®)
- Quadrivalent (A, C, W, Y) meningococcal polysaccharide (Menomune®)
- Serogroup B meningococcal (Bexsero® and Trumenba®)
- Meningitis in people with cochlear implants is most commonly caused by the bacteria Streptococcus pneumoniae (pneumococcus).
- There is no evidence that children with cochlear implants are more likely to get meningococcal meningitis caused by Neisseria meningitidis than children without cochlear implants.
- AAP: Policy Statement—Cochlear Implants in Children: Surgical Site Infections and Prevention and Treatment of Acute Otitis Media and Meningitis (2010)
- National Center on Birth Defects and Development Disabilities, Hearing Loss in Children, Treatment and Intervention Services
- FDA Public Health Notification: Importance of Vaccination in Cochlear Implant Recipients (2007)
- FDA Public Health Notification: Continued Risk of Bacterial Meningitis in Children with Cochlear Implants with a Positioner Beyond Twenty-Four Months Post-Implantation (2006)
- FDA Public Health Web Notification*: Risk of Bacterial Meningitis in Children with Cochlear Implants (2002/2003)
For more information about vaccines and vaccinations:
- Call CDC's Information Contact Center
- English and Español: 1-800-CDC-INFO (1-800-232-4636)
- TTY: 1-888-232-6348
- Biernath KR, Reefhuis J, Whitney CG, Mann EA, Costa P, Eichwald J, Boyle C. Bacterial meningitis among children with cochlear implants beyond 24 months after implantation. Pediatrics. 2006: 117;2:284-89.
- Reefhuis J, Honein M, Whitney C. et al. Risk of bacterial meningitis in children with cochlear implants. New England Journal of Medicine. 2003: 349;5:435-45.
- Wilson-Clark SD, Squires S, Deeks S, Centers for Disease Control and Prevention (CDC). Bacterial meningitis among cochlear implant recipients--Canada, 2002. MMWR. 2006; 55 Suppl 1:20.
- Cohen N, Ramos A, Ramsden R, et al. International consensus on meningitis and cochlear implants. Acta Otolaryngol. 2005; 125:916.
- Rubin LG, Papsin B, Committee on Infectious Diseases and Section on Otolaryngology-Head and Neck Surgery. Cochlear implants in children: surgical site infections and prevention and treatment of acute otitis media and meningitis. Pediatrics. 2010; 126:381.
- Thigpen MC, Whitney CG, Messonnier NE, Zell ER, Lynfield R, Hadler JL, et al. Bacterial meningitis in the United States, 1998-2007. N Engl J Med. 2011 May 26;364(21):2016-25.
- Hsu HE, Shutt KA, Moore MR, Beall BW, Bennett NM, Craig AS, et al. Effect of pneumococcal conjugate vaccine on pneumococcal meningitis. N Engl J Med. 2009 Jan 15;360(3):244-56.
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