Cochlear Implants and Vaccine Recommendations

A cochlear implant is a special hearing device. Having one raises the risk of certain kinds of bacterial meningitis — inflammation (swelling) of the lining of the brain and spinal cord — and vaccines can help prevent them.

The bacteria and the vaccines

The leading causes of bacterial meningitis in the United States, and the vaccines that help protect against each:

People with cochlear implants are at higher risk of bacterial meningitis, especially pneumococcal meningitis — something CDC and the Food and Drug Administration learned from a 2002 study of children with implants.

Hearing loss itself brings no special recommendations: people with hearing loss should get the same vaccines as everyone else for their age and health, and can raise questions about ear abnormalities and disease risk with an ear, nose and throat (ENT) doctor.

Pneumococcal vaccination

CDC recommends pneumococcal vaccination for children and adults with cochlear implants.

Children

• Under 5: the same pneumococcal vaccines as other children their age.
• 2 through 18: may need more. No extra dose is needed if at least one dose was PCV20; if none was, one more dose — PCV20 or PPSV23.
• 6 through 18 who have never had a pneumococcal conjugate vaccine: PCV15 or PCV20; if PCV15, follow it with one dose of PPSV23.

Adults

• Never vaccinated: one dose of PCV15, PCV20 or PCV21; if PCV15, follow it with one dose of PPSV23.
• Previously vaccinated: ask a healthcare provider whether more doses are recommended.

Hib and meningococcal vaccination

• Hib: no recommendation specific to implants. All children under 5 should get Hib vaccines, including those with implants; the data do not suggest older children or adults with implants need them.
• Meningococcal: no recommendation specific to implants, and the data do not suggest implants raise the risk of meningococcal meningitis. CDC recommends meningococcal vaccination for all preteens and teens, including those with implants.

Before or after surgery?

Get all recommended pneumococcal doses at least 2 weeks before implant surgery, for the best protection during and after it. Anyone already up to date on pneumococcal, Hib and meningococcal vaccines needs no extra doses before surgery.

Safety and limits

These vaccines have good safety records. Side effects are usually mild — a sore arm where the shot was given is common with some, and some people get a fever.

But vaccines do not protect against every bacterium that causes meningitis, nor always against every type of a given bacterium — pneumococcal vaccines cover many strains of S. pneumoniae, not all. People with weakened immune systems may also respond less well, leaving them at higher risk.

Sources

• Centers for Disease Control and Prevention, "Cochlear Implants and Vaccine Recommendations." https://www.cdc.gov/pneumococcal/vaccines/cochlear-implants.html
• The original's table lists "PPCV21" once; the vaccine is PCV21, as the rest of the page gives it.
• Rewritten in hubnx's own words.