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August 20, 2004

Meningitis vaccination vital after cochlear implantation

From: NT Online Clinical News - Aug 20, 2004

New research suggests that children under six given cochlear implants should also receive 7-valent pneumococcal conjugate vaccine (PCV-7) to prevent bacterial meningitis.

The authors of the study, published in The Journal of Infectious Diseases, say that older high risk implant patients, such as those with a history of meningitis, should also be immunised.

They say pneumococcal meningitis has emerged as a rare but serious risk after cochlear implantation and an earlier study found that cochlear implants are associated with a more than 30-fold increased risk of pneumococcal meningitis.

Children who have had bacterial meningitis are at particularly high risk of recurrence after cochlear implantation, but there have been concerns that routine vaccinations may not be adequate to prevent infection.

The current research studied the immunogenicity of pneumococcal vaccine in 174 cochlear implant patients.

A subgroup of patients received 23-valent pneumococcal polysaccharide vaccine (PPV-23) instead of PCV-7.

PPV-23 produced a weaker immune response than PCV-7, the researchers found.

The authors recommend immunization with PCV-7 for all cochlear implant recipients younger than 6, and for those 6 and older with risk factors, such as a history of bacterial meningitis or cranial malformation.

Reference: Rose M et al (2004) Immunogenicity of Pneumococcal Vaccination of Patients with Cochlear Implants J Infect Dis 190 (3) 551-557

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