Meningitis

Very rare one would get meningitis from the surgery, but as a preventive, it is imperative you receive the pneumococcal vaccine called PPV23 before the surgery. This one is for adults. For children under the age of 5 receive the "Prevnar” (PCV7). You get this needle at your family doctor's office and this is covered under Medicare.

When you are approved for the cochlear implant surgery by the surgeon, your audiologist will provide you a "guideline" that is shown below. This is just for your FYI as this is what I had received, however, please refer to the guideline your own audiologist and surgeon provides you.

Meningitis and Cochlear Implants

Meningitis is an infection of the lining of the brain. There are two main types of meningitis, viral and bacterial. Meningitis in people with cochlear implants is most commonly bacterial meningitis (e.g. - pneumococcal meningitis).

Having a cochlear implant may slightly increase the risk for meningitis. This risk can be lowered through vaccination for meningitis. There are Health Canada guidelines for meningitis vaccinations.

Vaccinations

There is an effective vaccination called “Prevnar” (PCV7) available from your family doctor for children age 5 and younger. This vaccination is covered by MSI as a routine immunization for all children.
The Nova Scotia schedule for Prevnar is ages 2 months, 4 months, 6 months and 18 months

For those over age 5 and adults, there is a pneumococcal vaccine called PPV23. This vaccination is covered by MSI.
Booster vaccinations are recommended five years after the first vaccination and are also covered by MSI for high risk groups such as cochlear implant users.

Guidelines for the administration of these vaccines are available from Health Canada, National Advisory Committee on Immunization (NACI) - Advisory Committee Statement of 1 April 2003, vol. 29, ACS-2-3. (see over)

Who is more at risk to develop meningitis?
Those under age 5 or over age 65
Those with anatomical malformations of the cochlea
Those with immune deficiencies
Those with deafness caused by a previous episode of meningitis

What are the recommendations of the NS Cochlear Implant Program?
The NS Cochlear Implant Program recommends vaccination following the Health Canada guidelines and NS schedule for immunizations. However, choosing not to have the vaccination will not prevent you from getting a cochlear implant.
Please take this information sheet to your family physician to discuss this vaccination.

Health Canada: National Advisory Committee on Immunization (NACI)
IMMUNIZATION RECOMMENDATIONS FORCOCHLEAR IMPLANT RECIPIENTS

Age at first dose and Immunization schedule:

2-6 months:

3 doses of pneumococcal conjugate vaccine (PCV7), 6-8 weeks apart
1 booster dose of PCV7 at 12-15 months
1 dose of pneumococcal polysaccharide vaccine (PPV23) at 2 years of age at least 8 weeks after the last dose of PCV7 **

7-11 months:

2 doses of PCV7, 6-8 weeks apart
1 booster dose of PCV7 at 12-15 months
1 dose of PPV23 at 2 years of age at least 8 weeks after the last dose of PCV7 **

12-23 months:

2 doses of PCV7, 6-8 weeks apart
1 dose of PPV23 at 2 years of age at least 8 weeks after the last dose of PCV7 **

24-59 months:

2 doses of PCV7 administered 8 weeks apart
1 dose of PPV23 at least 8 weeks after the second dose of PCV7 **

Individuals >= 5 years of age and above:

1 dose of PPV23**

Advisory Committee Statement of 1 April 2003, vol. 29, ACS-2-3

** PPV23 - Booster dose 5 years later is now recommended for all cochlear implant recipients