Joint Committee on Children’s Hearing: Position Statement on Vaccination Prior and After Cochlear Implantation

The article presents the position of experts from the Joint Committee on Infant Hearing on the role of immunoprophylaxis in patients with cochlear implants. It emphasizes that viral and bacterial infections are a significant cause of sensorineural hearing loss, underscoring the importance of routine vaccination as a primary prevention method. In cochlear implants patients, surgery and the presence of the implant create additional risks of infectious complications, including acute otitis media and meningitis. Particular attention is paid to the necessity of vaccination against pneumococcal, Haemophilus influenzae type b infections, as well as influenza. The authors recommend assessing vaccination status before and after surgery, administering immunizations according to the National Immunization Schedule, and implementing an individual schedule for high-risk groups. Specific vaccination regimens are provided, including the combined use of pneumococcal conjugate and polysaccharide vaccines. It is concluded that strategically sound immunoprophylaxis is a key factor in minimizing risks and enhancing the effectiveness of auditory-speech rehabilitation.

1. Tufatulin GSh, Koroleva IV. Epidemiological characteristics of the pediatric population of cochlear implant users in St. Petersburg. Russian Bulletin of Otorhinolaryngology. 2023;88(3):21–26. (In Russ). doi: https://doi.org/10.17116/otorino20228803121

2. Pashkov AV, Naumova IV, Voevodina KI, et al. Psychophysical and Electrophysiological Parameters of the Auditory Analyzer as Indicators of the Effectiveness of Cochlear Implantation in Children with Bilateral Deafness. Annals of the Russian Academy of Medical Sciences. 2023;78(5):400–407. (In Russ). doi: https://doi.org/10.15690/vramn10922

3. Neirosensornaya tugoukhost’ u detei: Clinical guidelines. Union of Pediatricians of Russia, National Medical Association of Otolaryngologists. Moscow; 2024. 65 p. (In Russ).

4. FDA. Cochlear Implants. In: Food and Drug Administration: Official website. Available online: https://www.fda.gov/search?s=cochlear+implantation. Accessed on February 13, 2026. 5. Chen X, Fu YY, Zhang TY. Role of viral infection in sudden hearing loss. J Int Med Res. 2019;47(7):2865–2872. doi: https://doi.org/10.1177/0300060519847860

5. Cohen BE, Durstenfeld A, Roehm PC. Viral causes of hearing loss: a review for hearing health professionals. Trends Hear. 2014;18:2331216514541361. doi: https://doi.org/10.1177/2331216514541361

6. Chen HC, Chung CH, Wang CH, et al. Increased risk of sudden sensorineural hearing loss in patients with hepatitis virus infection. PLoS One. 2017;12(4):e0175266. doi: https://doi.org/10.1371/journal.pone.0175266

7. Chen TYT, Chang R, Hung YM, et al. Association between human papillomavirus infection and sudden sensorineural hearing loss: a nationwide population-based cohort study. EClinicalMedicine. 2022;47:101402. doi: https://doi.org/10.1016/j.eclinm.2022.101402

8. WHO: 1 in 4 people projected to have hearing problems by 2050. 2021. In: World Health Organization: Official website. Available online: https://www.who.int/news/item/02-03-2021-who-1-in-4-people-projected-to-havehearing-problems-by-2050. Accessed on February 14, 2026.

9. Caversaccio M, Mantokoudis G, Wagner F, et al. Robotic Cochlear Implantation for Direct Cochlear Access. J Vis Exp. 2022:(184):e64047. doi: https://doi.org/10.3791/64047

10. Terry B, Kelt RE, Jeyakumar A. Delayed complications after cochlear implantation. JAMA Otolaryngol Head Neck Surg. 2015;141(11):1012–1017. doi: https://doi.org/10.1001/jamaoto.2015.2154

11. Benatti A, Castiglione A, Trevisi P, et al. Endocochlear inflammation in cochlear implant users: Case report and literature review. Int J Pediatr Otorhinolaryngol. 2013;77(6):885–893. doi: https://doi.org/10.1016/j.ijporl.2013.03.016

12. Anne S, Ishman SL, Schwartz S. A systematic review of perioperative versus prophylactic antibiotics for cochlear implantation. Ann Otol Rhinol Laryngol. 2016;125(11):893–899. doi: https://doi.org/10.1177/0003489416660113

13. Jiang Y, Gu P, Li B, et al. Analysis and management of complications in a cohort of 1,065 minimally invasive cochlear implantations. Otol Neurotol. 2017;38(3):347–351. doi: https://doi.org/10.1097/MAO.0000000000001302

14. Halawani R, Aldhafeeri A, Alajlan S, Alzhrani F. Complications of post-cochlear implantation in 1027 adults and children. Ann Saudi Med. 2019;39(2):77–81. doi: https://doi.org/10.5144/0256-4947.2019.77

15. Nisenbaum EJ, Roland JT, Waltzman S, Friedmann DR. Risk Factors and Management of Postoperative Infection Following Cochlear Implantation. Otol Neurotol. 2020;41(7):e823–e828. doi: https://doi.org/10.1097/MAO.0000000000002685

16. Vila PM, Ghogomu NT, Odom-John AR, et al. Infectious complications of pediatric cochlear implants are highly influenced by otitis media. Int J Pediatr Otorhinolaryngol. 2017;97:76–82. doi: https://doi.org/10.1016/j.ijporl.2017.02.026

17. Alanazi G, Alrashidi A, Alqarni K, et al. Meningitis post-cochlear implant and role of vaccination. Saudi Med J. 2022;43(12):1300– 1308. doi: https://doi.org/10.15537/smj.2022.43.12.20220426

18. Lander D., Durakovic N., Kallogjeri D., et al. Incidence of Infectious Complications Following Cochlear Implantation in Children and Adults. JAMA. 2020;323(2):182–183. doi: https://doi.org/10.1001/jama.2019.18611

19. Reefhuis J, Honein MA, Whitney CG, et al. Risk of bacterial meningitis in children with cochlear implants. N Engl J Med. 2003;349(5):435– 445. doi: https://doi.org/10.1056/NEJMoa031101

20. Pakdaman MN, Herrmann BS, Curtin HD, et al. Cochlear implantation in children with anomalous cochleovestibular anatomy: a systematic review. Otolaryngol Head Neck Surg. 2012;146(2):180– 190. doi: https://doi.org/10.1177/0194599811429244

21. Ou H, Cleary P, Sie K. Assessing the immunization status of pediatric cochlear implant recipients using a statemaintained immunization registry. Otolaryngol Head Neck Surg. 2010;143(4):487–491. doi: https://doi.org/10.1016/j.otohns.2010.05.020.

22. Lalwani AK, Cohen NL. Does meningitis after cochlear implantation remain a concern in 2011? Otol Neurotol. 2012;33(1):93– 95. doi: https://doi.org/10.1097/MAO.0b013e31823dbb08

23. Wei BP, Shepherd RK, Robins-Browne RM, et al. Pneumococcal meningitis threshold model: A potential tool to assess infectious risk of new or existing inner ear surgical interventions. Otol Neurotol. 2006;27(8):1152–1161. doi: https://doi.org/10.1097/01.mao.0000227898.80656.54

24. Hearing Loss in Congenital, Neonatal and Childhood Infections. Arısoy AE, Arısoy ES, Muluk NB, et al., eds. Springer Cham; 2023. 1112 p. doi: https://doi.org/10.1007/978-3-031-38495-0

25. Sun JQ, Sun JW, Hou XY. Cochlear implantation in Mondini’s deformity: could the straight electrode array with length of 31 mm be fully inserted? Acta Otolaryngol. 2017;137(7):712–715. doi: https://doi.org/10.1080/00016489.2017.1280849

26. Corrales CE, Fischbein N, Jackler RK. Imaging innovations in temporal bone disorders.Otolaryngol Clin North Am. 2015;48(2):263– 280. doi: https://doi.org/10.1016/j.otc.2014.12.002

27. Wolber P, Shabli S, Anagiotos A, et al. The diagnostic value of computed tomography in delayed complications after cochlear implantation. Acta Otolaryngol. 2021;141(2):111–116. doi: https://doi.org/10.1080/00016489.2020.1829702

28. Order of the Ministry of Health of Russian Federation dated December 6, 2021 No. 1122н “Ob utverzhdenii natsional’nogo kalendarya profilakticheskikh privivok i kalendarya profilakticheskikh privivok po ehpidemicheskim pokazaniyam”. (In Russ).

29. Meditsinskie protivopokazaniya k provedeniyu profilakticheskikh privivok preparatami natsional’nogo kalendarya privivok: Methodological guidelines. Moscow: Federal Center for State Sanitary and Epidemiological Surveillance of the Ministry of Health of Russian Federation; 2002. 16 p. (In Russ).

30. Tsuji RK, Hamerschmidt R, Lavinsky J, et al. Brazilian Society of Otology task force — cochlear implant — recommendations based on strength of evidence. Braz J Otorhinolaryngol. 2025;91(1):101512. doi: https://doi.org/10.1016/j.bjorl.2024.101512

31. Jin L, Téllez P, Chia R, et al. Improving vaccination uptake in pediatric Cochlear implant recipients. J Otolaryngol Head Neck Surg. 2018;47(1):56. doi: https://doi.org/10.1186/s40463-018-0308-5

32. Kahue CN, Sweeney AD, Carlson ML, Haynes DS. Vaccination recommendations and risk of meningitis following cochlear implantation. Curr Opin Otolaryngol Head Neck Surg. 2014;22(5):359– 366. doi: https://doi.org/10.1097/MOO.0000000000000092

33. Wei BP, Shepherd RK, Robins-Browne RM, et al. Pneumococcal meningitis post-cochlear implantation: preventative measures. Otolaryngol Head Neck Surg. 2010;143(5 Suppl 3):S9–14. doi: https://doi.org/10.1016/j.otohns.2010.08.011

34. Tay S, Bowen AC, Blyth CC, et al. A quality improvement study: Optimizing pneumococcal vaccination rates in children with cochlear implants. Vaccine. 2022;40(32):4531–4537. doi: https://doi.org/10.1016/j.vaccine.2022.06.022

35. Piotrowska A, Paradowska-Stankiewicz I, Skarżyński H. Rates of Vaccination against Streptococcus Pneumoniae in Cochlear Implant Patients. Med Sci Monit. 2017;23:4567–4573. doi: https://doi.org/10.12659/msm.903188

36. Vaktsinoprofilaktika pnevmokokkovoi infektsii u detei i vzroslykh: metodicheskie rekomendatsii. Baranov AA, Namazova-Baranova LS, Briko NI, eds.; Union of Pediatricians of Russia. Moscow: Pediatr; 2023. 92 p. (In Russ).

37. Immunizatsiya immunokomprometirovannykh patsientov: Methodological recommendations. Moscow; 2025. 220 p. (In Russ).

38. Rubin LG, Levin MJ, Ljungman P, et al. 2013 IDSA Clinical Practice Guideline for Vaccination of the Immunocompromised Host. Clin Infect Dis. 2014;58(3):309–318. doi: https://doi.org/10.1093/cid/cit816

39. Rubin LG, Papsin B. Cochlear implants in children: surgical site infections and prevention and treatment of acute otitis media and meningitis. Pediatrics. 2010;126(2):381–391. doi: https://doi.org/10.1542/peds.2010-1427

40. Meningokokkovaya infektsiya u detei: Clinical guidelines. Ministry of Health of Russian Federation; 2023. 72 p. (In Russ).

41. Resolution of the Chief State Sanitary Doctor of the Russian Federation dated January 28, 2021 No. 4 “Ob utverzhdenii sanitarnykh pravil i norm SanPiN 3.3686-21 “Sanitarno-ehpidemiologicheskie trebovaniya po profilaktike infektsionnykh boleznei”. (In Russ).

42. Briko NI, Feldblyum IV. National Concept of Development of Vaccine Prophylaxis in Russia. Epidemiology and Vaccinal Prevention. 2024;23(2):114–123. (In Russ). doi: https://doi.org/10.31631/2073-3046-2024-23-2-114-123

43. Baranov AA, Namazova-Baranova LS, Tatochenko VK, et al. Immunoprofilaktika meningokokkovoi infektsii u detei: Methodological recommendations. Union of Pediatricians of Russia. 2nd edn., revised and enlarged. Moscow: Pediatr; 2019. 36 p. (In Russ).

44. Pneumococcal Disease. Vaccines for People with Cochlear Implants. In: Centers for Disease Control and Prevention (CDC): Official website. Available online: https://www.cdc.gov/vaccines/vpd/mening/hcp/dis-cochlear-gen.html. Accessed on February 15, 2026.

45. Vaccines & Immunizations. CDC Vaccine Schedules App for Healthcare Providers. In: Centers for Disease Control and Prevention (CDC): Official website. Available online: https://www.cdc.gov/vaccines/hcp/imz-schedules/app.html. Accessed on February 15, 2026.

46. Pneumococcal Disease. Cochlear Implants and Vaccine Recommendations. In: Centers for Disease Control and Prevention (CDC): Official website. Available online: https://www.cdc.gov/pneumococcal/vaccines/cochlear-implants.html#:~:text=Haemophilus%20influenzae%20(causes%20H.,Pneumococcal%20meningitis. Accessed on February 15, 2026.