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Cochlear Implants & Meningitis Vaccination

Q&A for the General Public

At a Glance

Certain vaccines may help prevent meningitis in persons with cochlear implants. For best protection, people with cochlear implants should keep up-to-date with all recommended vaccinations.


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General Questions

How do we know about a link between cochlear implants and bacterial meningitis?

CDC and the Food and Drug Administration (FDA) carried out a study in 2002 to learn more about a possible link between cochlear implants and bacterial meningitis in children. The study found that bacterial meningitis occurred more often in children with all types of cochlear implants than in children of the same age group in the general population. Early in the investigation it was recognized that people with cochlear implants may be at increased risk for bacterial meningitis – especially pneumococcal meningitis caused by the bacteria Streptococcus pneumoniae. Since some pneumococcal meningitis is vaccine-preventable, CDC recommended people with cochlear implants receive age-specific pneumococcal vaccination according to the high-risk schedules. These recommendations are supported by the findings of this investigation and were adopted by the U.S. Advisory Committee on Immunization Practices (ACIP) in June 2003.

To learn more about the findings of this investigation, visit "The Early Hearing Detection and Intervention Program" (EHDI) web page about Cochlear Implants and Meningitis.

When should persons with cochlear implants receive the pneumococcal vaccines (PCV13, PPSV23)?

Two pneumococcal vaccines are available to protect children with cochlear implants against meningitis. The pneumococcal conjugate vaccine (PCV13) should be given within the first two years of life according to the Childhood Immunization Schedule.

The pneumococcal polysaccharide vaccine (PPSV23) is also recommended for cochlear implant recipients and those awaiting placement of a cochlear implant. These individuals should receive one dose of PPSV23 after they reach 2 years of age, and at least 2 months after the last dose of PCV13.

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Should persons with cochlear implants receive the Hib vaccine?

Children younger than 5 years of age should receive the Haemophilus influenzae type b (Hib) vaccine as a routine protection, according to the Childhood Immunization Schedule. Most children born after 1990 received Hib vaccine as infants.

For those age 5 years and older, Hib vaccine is not routinely recommended because most older children and adults are already immune to Hib, even if they have not received the Hib vaccine. Available information does not suggest children or adults aged ≥5 years with cochlear implants need Hib vaccination. However, Hib vaccine can be given to older children and adults who have never received it.

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Should persons with cochlear implants receive the meningitis (meningococcal) vaccine?

Adolescents 11 through 18 years of age should receive the meningococcal conjugate vaccine as a routine protection, according to the Adolescent Immunization Schedule. The meningococcal vaccine protects against meningitis caused by some types of Neisseria meningitidis bacteria, also called meningococcus. There is no information to suggest that persons with cochlear implants are at increased risk for meningococcal meningitis. Therefore, meningococcal vaccine is not routinely recommended for persons with cochlear implants, unless they have other reasons to get this vaccine.

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When should people planning to receive a cochlear implant be vaccinated against meningitis?

Persons scheduled to receive cochlear implants should make sure they are up-to-date on pneumococcal vaccinations at least two weeks before surgery to provide maximum protection both during and after surgery. In addition, parents of children younger than 5 years old should be sure their child has received the right number of Hib doses two or more weeks before surgery. Persons already up to date on these vaccines do not need extra doses before surgery. Meningococcal vaccine is usually not needed before or after cochlear implant surgery.

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Is hearing loss a reason to receive meningitis vaccines?

Currently, there are no special immunization recommendations for persons with hearing loss unless they have (or are planning to receive) a cochlear implant or have other risks factors for meningitis. Persons with hearing loss should receive the vaccines that are recommended for persons without hearing loss, based on age and other health conditions. Persons with hearing loss who are known to have an ear condition that puts them at risk for meningitis should get the pneumococcal vaccines for high risk groups. People with hearing loss should discuss questions about possible ear abnormalities with an ear, nose, and throat (ENT) doctor.

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Should people with cochlear implants who have had bacterial meningitis in the past be vaccinated against meningitis?

A past case of meningitis caused by pneumococcal bacteria does not provide enough protection against getting this form of meningitis again and age-specific vaccination is still recommended.

Children who had Hib meningitis when they were younger than 2 years of age may need additional doses of Hib vaccine, depending on their current age. Children who are 2 years or older when they develop Hib meningitis are considered immune to Hib and do not need more Hib vaccinations.

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What side effects occur with vaccines that prevent meningitis?

The vaccines used to protect against meningitis are safe. When side effects occur, they are usually mild. Local reactions, such as a sore arm at the site of the injection, are fairly common with some of the vaccines. Mild fever may also occur. More information about the side effects of the meningitis vaccines can be found on the vaccine side effects web page.

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Can vaccines prevent all meningitis in persons with cochlear implants?

Vaccines can't prevent all meningitis in persons with cochlear implants. Although vaccines against meningitis are highly effective, we don't have vaccines for all bacteria that cause meningitis. Pneumococcal vaccines protect against many of the most common strains but not against all strains. Also, people with immune system problems may respond poorly to vaccines.

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