Use of Vaccines to Prevent Meningitis in Persons with Cochlear Implants
- People with cochlear implants are more likely to get bacterial meningitis than people without cochlear implants. In addition, some people who are candidates for cochlear implants have anatomic factors that may increase their risk for meningitis. These factors include facial and cranial abnormalities, including of the temporal bone and cochlea.
- The bacteria Streptococcus pneumoniae (pneumococcus) causes most cases of meningitis in people with cochlear implants.
- Due to their increased risk, CDC recommends pneumococcal vaccination for people who have or are candidates for cochlear implants. Clinicians should follow the pneumococcal vaccine recommendations that apply to other groups at increased risk.
- Recommendations for the timing and type of pneumococcal vaccination vary with age and vaccination history. See Advisory Committee on Immunization Practices (ACIP) recommendations highlighted in the box to the right for details.
CDC recommends a pneumococcal conjugate vaccine (PCV13 or PCV15 for children and PCV15 or PCV20 for adults) for people who have or are candidates for cochlear implants. CDC also recommends pneumococcal polysaccharide vaccine (PPSV23) for some people 2 years and older who have or are candidates for cochlear implants. Specifically, PPSV23 is recommended for children once all recommended doses of PCV13 or PCV15 have been administered and for adults who received PCV15.
See Pneumococcal Vaccination: Summary of Who and When to Vaccinate for more detail. Download the PneumoRecs VaxAdvisor Mobile App for Vaccine Providers for help determining which pneumococcal vaccines a patient needs and when.
There is no evidence people with cochlear implants are more likely to get Haemophilus influenzae type b (Hib) meningitis or meningococcal meningitis than people who do not have cochlear implants. However, Hib and meningococcal vaccines are routinely recommended based on age and other risk factors.
- The following Hib and meningococcal vaccines are available in the United States:
- Hib conjugate (ActHIB®, Hiberix®, PedvaxHIB®, Pentacel®, Vaxelis®)
- Meningococcal conjugate (Menactra® and Menveo®)
- Serogroup B meningococcal (Bexsero® and Trumenba®)
- See Vaccine-specific ACIP Recommendations for information about how, when, and which pneumococcal, Hib, and meningococcal vaccines can be given together.
- 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
- Kahue CN, Sweeney AD, Carlson ML, Haynes DS. Vaccination recommendations and risk of meningitis following cochlear implantation. Curr Opin Otolaryngol Head Neck Surg. 2014;22(5):359–66.
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- Lalwani AK and Cohen NL. Longitudinal risk of meningitis after cochlear implantation associated with the use of the positioner. Otol Neurotol. 2011;32(7):1082–5.
- Thigpen MC, Whitney CG, Messonnier NE, et al. Bacterial meningitis in the United States, 1998-2007. N Engl J Med. 2011;364(21):2016–25.
- Cohen NL and Hirsch BE. Current status of bacterial meningitis after cochlear implantation. Otol Neurotol. 2010;31(8):1325–8.
- 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.
- Hsu HE, Shutt KA, Moore MR, et al. Effect of pneumococcal conjugate vaccine on pneumococcal meningitis. N Engl J Med. 2009;360(3):244–56.
- Mancini P, D’Elia C, Bosco E, et al. Follow-up of cochlear implant use in patients who developed bacterial meningitis following cochlear implantation. Laryngoscope. 2008;118(8):1467–71.
- Biernath KR, Reefhuis J, Whitney CG, et al. Bacterial meningitis among children with cochlear implants beyond 24 months after implantation. Pediatrics. 2006:117;2:284–89.
- Wilson-Clark SD, Squires S, Deeks S, Centers for Disease Control and Prevention (CDC). Bacterial meningitis among cochlear implant recipients–Canada, 2002. MMWR Morb Mortal Wkly Rep. 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.
- Cohen NL, Roland JT Jr, Marrinan M. Meningitis in cochlear implant recipients: the North American experience. Otol Neurotol. 2004;25(3):275–81.
- Nadol JB Jr Eddington DK. Histologic evaluation of the tissue seal and biologic response around cochlear implant electrodes in the human. Otol Neurotol. 2004;25(3):257–62.
- Reefhuis J, Honein M, Whitney C, et al. Risk of bacterial meningitis in children with cochlear implants. N Engl J Med. 2003:349;5:435–45.