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. 

In early 2023, the CDC updated pneumococcal vaccination recommendations for pediatric and adult cochlear implant patients to reflect approval of two new vaccines, called PCV20 and PCV15. See below:

2023 CDC Guidelines

Adult guidelines for pneumococcal vaccination for cochlear implant patients

• Adults ages 19-64: Give one dose of Prevnar 20 (PCV20), then vaccines are complete. If Pneumovax 23 (PPSV23) was used, give one dose of PCV20 one year later, then vaccines are complete. If PCV13 was used, give one dose of PCV20 one year later, then vaccines are complete. This applies to those who only got Prevnar 7: give one dose of PCV20, then vaccines are complete.
• Adults 65 and up: Those who never received any pneumococcal vaccines, get one dose of PCV20, then vaccines are complete. For those who only got Prevnar 13, give one dose of PCV20 or PPSV23, and their vaccines will be complete. Give one year after Prevnar 13. If they only got PPSV23, give one dose of PCV20 one year after the dose of PPSV23, then their vaccines are complete. If they got PCV13 at any age and PPSV23 before age 65, give PCV20 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 (PCV13) or PCV15 to Prevnar 20 (PCV20). PCV20 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 PCV13 was given in three doses prior to 12 months old, give one dose of PCV20 eight weeks after the last pneumococcal vaccine. If less than three doses of PCV13 was given before age 24 months, give two doses of PCV20 eight weeks apart, then they are complete. If Pneumovax 23 (PPSV23) was given after age 24 months, their vaccines are complete. If no PPSV23 was given, give one dose of PCV20 or PPSV23 eight weeks after last PCV13, then their vaccines are complete.
• Ages 2 to 5 years: If no vaccines at all, give PCV20 in two doses eight weeks apart, then their vaccines are complete.
• Ages 6 through 18 years: If they received PCV13 or PCV15 before age 6 but never received PCV20, give PCV20 in one dose if no PPSV23 used. Their vaccines will then be complete. If they had PPSV23, their vaccines are complete.

Please send proof of vaccination to:

• Barbara Gottschalk, MSN, CRNP
  • 410-955-6554
  • [email protected]
• Rachel Hisim, MSN, CRNP
  • 443-287-4983
  • [email protected]

Updated in November 2023.