Advice for Patients with Cochlear Implants: New Information on Meningitis Risk
The Listening Center team at Johns Hopkins wants to provide you with important new information about pneumococcal vaccination and how to best reduce the risk of meningitis. The CDC has new vaccine requirements (October 2012) for pneumococcal vaccination in cochlear implant patients:
- Young Children (younger than 2y) – A full schedule of Prevnar 13 vaccines should be administered as routinely required in the U.S.
- Young Children (older than 2y) – One dose of PPV23 or Pneumovax should be given at age 2 years. If the last dose of Prevnar 13 is given after age 2 years, then Pneumovax should be administered 8 weeks later.
- Adults (age 19y and older) who have NOT had any prior pneumococcal vaccinations now need one dose of Prevnar 13 followed 8 weeks later by PPV23 or Pneumovax. A Pneumovax booster is required at age 65 years.
- Adults (age 19y and older) who have had prior vaccination only with Pneumovax, now also need one dose of Prevnar 13 to be given 1 year or more after their Pneumovax shot. A Pneumovax booster is required at age 65 years.
Cochlear implant candidates must have completed at least part of the immunization requirements prior to surgery. Full compliance with the full immunization schedule must be documented as soon as possible.
Pneumococcal vaccination protects against Streptococcus pneumoniae (commonly referred to as pneumococcus), the bacterium most commonly responsible for meningitis after cochlear implant surgery. Although extremely rare, meningitis has been reported worldwide in 200 patients with cochlear implants, and has unfortunately led to 28 deaths. We therefore take this matter very seriously. To minimize the risk of infection, we require all cochlear implant patients to receive age-appropriate pneumococcal vaccination and to provide us with proof of vaccination. We are taking these precautions in accordance with guidelines established by the Food and Drug Administration (FDA), Center for Disease Control (CDC), and state health departments.
The Listening Center asks that your (or your child’s) primary care physician sign the Proof of Pneumococcal Vaccination Form and return it to us via fax at (410)-614-9167, (Attention: Barbara Gottschalk) as soon as possible.
If for any reason you do not wish to receive the Pneumovax vaccine, please sign a waiver which states that you understand the risks of pneumococcal meningitis in individuals with cochlear implants and are knowingly refusing to receive the vaccination. If you have not yet had surgery, your surgeon may refuse to operate if you or your children are not properly vaccinated.
For more information and as a reference for your primary care physician or pediatrician, please visit the CDC website. Thank you for assisting us. If you have any questions, please contact me.
Updated: February 5, 2013