All cochlear implant users and all patients anticipating cochlear implantation should receive pneumococcal vaccination to reduce the risk of ear infections that can lead to pneumococcal meningitis.  

Pneumococcal vaccination protects against Streptococcus pneumoniae (commonly referred to as pneumococcus), the bacteria most commonly responsible for meningitis after cochlear implant surgery.  Although extremely rare, bacterial meningitis can be fatal and has been reported worldwide in 200 patients with cochlear implants since 1980. We therefore take this matter very seriously.  To minimize the risk of infection, we require all cochlear implant users and candidates to receive age-appropriate pneumococcal vaccination and to provide us with proof of vaccination. We take these precautions in accordance with guidelines established by the Food and Drug Administration (FDA), Centers for Disease Control and Prevention (CDC) and state health departments.  

2024 CDC Guidelines

Adult guidelines for pneumococcal vaccination for cochlear implant patients, adapted from the new CDC guidelines, 9/12/2024.

• Adults ages 19-64: Give one dose of Prevnar 20 (PCV 20) or PCV 21, then vaccines are complete. If Pneumovax 23 (PPSV 23) was used, give one dose of PCV 20 or PCV 21, one year later; then vaccines are complete. If PCV 13 was used, give one dose of PCV 20 or PCV 21, one year later; then vaccines are complete. This applies to those who only got Prevnar 7: give one dose of PCV 20 or PCV 21; then vaccines are complete.
  
   
• Adults 65 and up: Those who never received any pneumococcal vaccines: get one dose of PCV 20 or PCV 21, and their vaccines are complete. If they only got Prevnar 13, give one dose of PCV 20, PCV 21 or PPSV 23, and their vaccines will be complete. Give one year after Prevnar 13. If they only got PPSV 23, give one dose of PCV 20 or PCV 21, one year after the dose of PPSV 23. Then their vaccines are complete. If they got PCV 13 at any age and PPSV 23 before age 65, give PCV 20 or PCV 21 five years after the last pneumococcal vaccine. Then their vaccines are complete.
  
   

Pneumococcal guidelines for pediatric cochlear implant surgery patients

• Ages 2 and younger: The full vaccine series will soon transition from Prevnar 13 (PCV 13) or PCV 15 to Prevnar 20 (PCV 20). PCV 20 is to be given at ages 2 months, 4 months, 6 months, and 12 months to 15 months. Once these four are given, vaccines are complete.
• Ages 2 to 5 years, to catch up: If PCV 13 was given in three doses prior to 12 months old, give one dose of PCV 20 eight weeks after the last pneumococcal vaccine. If less than three doses of PCV 13 was given before age 24 months, give two doses of PCV 20 eight weeks apart; then they are complete. If Pneumovax 23 (PPSV 23) was given after age 24 months, their vaccines are complete. If no PPSV 23 was given, give one dose of PCV 20 or PPSV 23 eight weeks after the last PCV 13; then their vaccines are complete.
• Ages 2 to 5 years: If no vaccines at all, give PCV 20 in two doses eight weeks apart; then their vaccines are complete.
• Ages 6 through 18 years: If they received PCV 13 or PCV 15 before age 6 but never received PCV 20, give PCV 20 in one dose if no PPSV 23 used. Their vaccines will then be complete. If they had PPSV 23, their vaccines are complete.

Please send proof of vaccination to:

• Rachel Hisim, CRNP, MSN
  • 443-287-4983
  • [email protected]

Failure to be properly vaccinated puts you at risk for meningitis caused by the bacterium strep pneumoniae. Your surgeon may refuse to operate if you are not fully vaccinated.

Updated in September 2024.