Diseases > Meningitis > Cochlear Implants
Cochlear Implants and Meningitis Vaccination
for the General Public

July 30, 2003 (originally published October 2002)

1. What are the CDC and other government agencies doing about meningitis in persons with cochlear implants?
   
   CDC, state health departments, and the FDA have completed an investigation to learn about the association between cochlear implants and meningitis. This public health response was carried out very quickly to ensure that this concern was addressed promptly.

   To learn more about the findings of this investigation, visit "The Early Hearing Detection and Intervention Program" (EHDI) web page about Cochlear Implants and Meningitis. (http://www.cdc.gov/ncbddd/ehdi/cochlear/)

   The results of this rapid public health investigation did not tell us whether a child with hearing loss who gets a cochlear implant has a higher chance of getting meningitis than a child with hearing loss who does not get a cochlear implant. To answer that question, CDC is working with a Danish university to conduct another study.

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2. Should persons with cochlear implants receive the Hib vaccine?
   

Children less than aged 5 years should receive the Haemophilus influenzae type b (Hib) vaccine as a routine protection, according to the 2003 Childhood Immunization Schedule. Most children born after 1990 received Hib vaccine as infants.

For those age 5 years and older, Hib vaccine is not routinely recommended because most older children and adults are already immune to Hib, even if they have not received the Hib vaccine. Available information does not suggest children or adults of age 5 or older with cochlear implants need Hib vaccination. However, Hib vaccine can be given to older children and adults who have never received it. For information about Hib vaccine, see the convenient vaccine chart at http://www.cdc.gov/nip/vaccine/vac-chart-public.htm

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3. Should persons with cochlear implants receive the meningitis (meningococcal) vaccine sometimes recommended for college students?
   
   The meningococcal vaccine given to many college students protects against meningitis caused by some types of Neisseria meningitidis, also called meningococcus. There is no information to suggest that persons with cochlear implants are at increased risk for meningococcal meningitis. Therefore, meningococcal vaccine is not routinely recommended for persons with cochlear implants, unless they have other reasons to get this vaccine.
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4. What should children with cochlear implants who missed doses of the pneumococcal conjugate vaccine do?
   

   The pneumococcal conjugate vaccine (PCV-7) shortage has ended and all communities should have vaccine available. Children aged less than 5 years with cochlear implants who missed doses of pneumococcal conjugate vaccine during the shortage should receive additional doses according to the catch-up schedule for children at increased risk. The recommended PCV-7 regimens are available on a chart in this Morbidity and Mortality Weekly Report (MMWR) article http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5219a6.htm

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5. When should people planning to receive a cochlear implant be vaccinated against meningitis?
   
   To provide maximum protection during and after surgery, persons scheduled to receive cochlear implants should make sure two or more weeks before surgery, they are up-to-date, for their age, on pneumococcal vaccinations recommended for people at increased risk. In addition, parents of children aged <5 years should also be sure their child has received the right number of Hib doses two or more weeks before surgery. Persons already up to date on these vaccines do not need extra doses before surgery. Meningococcal vaccine is usually not needed before or after cochlear implant surgery.
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6. Is hearing loss a reason to receive meningitis vaccines?
   
   Currently, there are no special immunization recommendations for persons with hearing loss unless they have (or are planning to receive) a cochlear implant or have other risks factors for meningitis. Persons with hearing loss should receive the vaccines that are recommended for persons without hearing loss, based on age and other health conditions. However, certain people with hearing loss may have a higher risk of meningitis than people without hearing loss. This higher risk may occur even if they do not have a cochlear implant. For example, some people with hearing loss were made deaf by a past case of meningitis, and these people may be especially prone to meningitis. Also, some persons with hearing loss may be more likely to get meningitis because part of the inner ear is not formed correctly. Persons with hearing loss who are known to have an ear condition that puts them at risk for meningitis should get the pneumococcal vaccines for high risk groups. People with hearing loss should discuss questions about possible ear abnormalities with an ear, nose, and throat (ENT) doctor.

   The recent cochlear implant and meningitis investigation showed that children with cochlear implants were more likely to get bacterial meningitis than children in the general population. More research is needed to better understand if persons with hearing loss without cochlear implants are at greater risk for meningitis. CDC is working with a Danish university to study this issue further.

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7. Should people with cochlear implants who have had bacterial meningitis in the past be vaccinated against meningitis?
   
   A past case of meningitis caused by pneumococcal bacteria does not provide enough protection against getting this form of meningitis again and age-specific vaccination is indicated.

   Children who had Hib meningitis when they were under 2 years of age may need additional doses of Hib, depending on their current age. Children who are aged 2 years of older when they develop Hib meningitis are considered immune to Hib and do not need more Hib vaccinations.

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8. What side effects occur with vaccines that prevent meningitis?
   
   The vaccines used to protect against meningitis are safe. When side effects occur, they are usually mild. Local reactions, such as a sore arm at the site of the injection, are fairly common with some of the vaccines. Mild fever may also occur. More information about the side effects of the meningitis vaccines can be found on the vaccine side effects web page.
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9. How have the immunization recommendation for persons with cochlear implants recently changed?
   
   Before the cochlear implant and meningitis investigation started, there were no special immunization recommendations for persons with cochlear implants. Early in the investigation, in October 2002, it was recognized that people with cochlear implants may be at increased risk for bacterial meningitis – especially pneumococcal meningitis. Since most pneumococcal meningitis is vaccine-preventable, CDC recommended people with cochlear implants receive age-specific pneumococcal vaccination according to the high-risk schedules. These recommendations are supported by the findings of this investigation and were adopted by the U.S. Advisory Committee on Immunization Practices (ACIP) in June 2003.

10. Can vaccines prevent all meningitis in persons with cochlear implants?
    
    Vaccines can't prevent all meningitis in persons with cochlear implants. Although vaccines against meningitis are highly effective, we don't have vaccines for all bacteria that cause meningitis. Pneumococcal vaccines protect against the most common strains but not against all strains. Also, people with immune system problems may respond poorly to vaccines.
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This page last modified on July 30, 2003