Assessing the Impact of Vaccination Status on Meningitis Risk Post Cochlear Implantation.

Objective: To better understand the protective benefit of pneumococcal vaccines on rates of meningitis after cochlear implantation.

Study design: Retrospective large database review.

Setting: Several studies have shown that cochlear implantation increases the incidence of bacterial meningitis, mostly due to pneumococcal meningitis. However, there are no studies that have demonstrated that pneumococcal vaccination is associated with a decreased risk of meningitis among cochlear implant recipients.

Methods: TriNetX, an electronic medical record database, was queried for incidence of meningitis after cochlear implantation, with and without pneumococcal vaccination.

Results: There are a total of 35,434 patients in the TriNetX database who have received a cochlear implant. Of these patients, 9803 patients (27.7%) had coding sufficient to assess their immunization status and were included in our study. Of the patients in our study, 9264 patients (93.7%) had evidence of receiving a PCV immunization, while 539 (5.5%) were found to be under vaccinated. A total of 258 patients in our study had an episode of meningitis after cochlear implantation, translating to an overall rate of 2.6%. The vaccinated group demonstrated a significantly lower incidence of meningitis (2.5%, n = 236) compared to the under-vaccinated group (4.1%, n = 22) (relative risk: 1.60; confidence interval (1.0441, 2.4586); P < .0310).

Conclusion: Our study provides evidence that pneumococcal vaccination is associated with a significantly lower rate of bacterial meningitis after cochlear implantation. Meningitis is a potentially life-threatening complication. Better adherence to pneumococcal vaccination guidelines pre- and post-CI is critical to reducing the feared risk of bacterial meningitis after cochlear implantation.