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Children with cochlear implants require full vaccination
Cochlear implants with a positioner pose the greatest risk for bacterial meningitis.
The FDA’s Center for Devices and Radiological Health recently sent out a public health notification reminder that children with cochlear implants who also have a positioned component are at an increased risk for bacterial meningitis caused by Streptococcus pneumoniae and therefore need to be fully immunized.
According to the FDA, there have been two deaths from meningitis in children implanted with the cochlear implant positioner within the past year. These children were aged between 9 and 11 years and had only completed part of the recommended pneumococcal vaccinations for their age group.
John Niparko, MD, and colleagues conducted a survey including the Johns Hopkins University cochlear implant patient population and found that 29% of the parents or guardians of patients younger than 2 years of age were uncertain of the child’s vaccination status.
Among children older than 2 years, vaccination status was unknown for 43% of the popula- tion, and 12% of children were not fully immunized.
These findings suggest that patients are not receiving vital preventive care, which can reduce their risk of life-threatening illness, according to the FDA.
Along with the FDA, the CDC, cochlear implant manufacturers and professional societies are working together to heighten awareness of the importance of vaccination in the cochlear implant population.
The FDA’s recommendations to decrease the risk for bacterial meningitis in cochlear implant recipients are to:
- Follow the CDC’s vaccination recommendations. Health care providers and families should review vaccination records of current and prospective cochlear implant recipients to ensure that the patient is current on all the CDC recommended vaccinations.
- Recognize the signs of meningitis early. This may help to ensure early detection and treatment of this life-threatening illness.
- Diagnose and treat middle ear infections properly. In some of the meningitis cases reported to the FDA, cochlear implant recipients had signs of middle ear infection prior to surgery or before the meningitis developed.
- Consider prophylactic antibiotics. Health care providers should consider prophylactic antibiotic treatment preoperatively in children receiving cochlear implants.
The CDC currently recommends this population receive pnemococcal vaccination under the same schedules that apply to those at high risk for invasive pneumococcal disease.
For more information on the CDC’s vaccination recommendations, visit www.cdc.gov/vaccines/vpd-vac/mening/cochlear/dis-cochlear-gen.htm.