Immunization Awareness

The Importance of Vaccinations in Cochlear Implant Users

To our cochlear implant patients and families:

As you know, cochlear implant surgery is a safe and effective way to restore hearing for  infants, children, and adults with severe to profound hearing loss. However, there is a small risk of meningitis that can occur following cochlear implant surgery, especially in patients who have abnormal inner ears, a cerebrospinal fluid (CSF) leak during implant surgery, or a history of meningitis.

The Centers for Disease Control (CDC) recommends that all patients with cochlear implants receive PNEUMOCOCCAL (not meningococcal) vaccination and we congratulate all of you who are up to date with your vaccinations. 
However, recently the CDC has updated its’ recommendations for safest coverage of cochlear implant recipients.  (The CDC guidelines are listed below and can also be found on the Internet at:  Please read the guidelines below and understand which applies. Proper vaccinations can literally mean the difference between life and death.
All implant candidates and patients who already have one or two cochlear implants must be vaccinated to decrease the risk of meningitis following surgery.
Note: The terminology can be confusing.  There are 2 different pneumococcal vaccinations, PCV13 (Prevnar®) – traditionally given to children, and PPSV23 (Pneumovax® 23 – traditionally given to adults)

CHILDREN (18 years old or younger)

  1. Infants with cochlear implants who are younger than age 2 should complete the Prevnar® series (part of the routine vaccination schedule for virtually all infants)
  1. Children with cochlear implants aged 2 years and older who have completed the Prevnar® series should receive one dose of Pneumovax® 23.  They should wait at least 2 months after the last dose of Prevnar® before receiving Pneumovax® 23.
  1. Children with cochlear implants who are between 24 and 59 months of age who have never received either Prevnar® or Pneumovax® 23 should receive two doses of Prevnar® two or more months apart and then receive one dose of Pneumovax® 23 at least two months after that.
  1. Children aged 5 years and older with cochlear who never received either vaccination, should receive a single dose of Prevnar® followed by one dose of Pneumovax® 23 two months after that.

ADULTS (over age 19)

  1. If you have never received either Prevnar® or Pneumovax® 23, you should receive a dose of Prevnar® first, followed by a dose of Pneumovax® 23 at least 2 months later.
  1. Adults with cochlear implants who previously have received at least 1 dose of Pneumovax® 23 should be given a Prevnar® dose 1 year or more after the last Pneumovax® 23 dose was received.   Adults who are now over age 65 should also consider receiving a booster Pneumovax® 23 vaccination.

Please note that if you are going to have cochlear implantation (or re-implantation), do not get a vaccination within 2 weeks prior to your surgery.  If you have not completed the recommendations, don’t worry – surgery won’t have to be delayed.  Just stay on schedule with your vaccinations.

Please bring this letter to your next appointment with your primary care doctor or pediatrician so that you can discuss this issue and assure that the correct pneumococcal vaccine(s) will be given.    
We will need you or your doctor to send or fax us written verification that the correct pneumococcal vaccine was given.

Our fax number is: (804) 628-0950.

We appreciate your help in keeping cochlear implant surgery safe for all of our patients!







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