Skip to main content
AAO-HNSF 2024 Annual Meeting & OTO EXPO Main banner
Icon Legend
This session is not in your schedule.
This session is in your schedule. Click again to remove it.
Back

Late-Breaking Scientific Oral Presentations

Otology/Neurotology

Session: Late-Breaking Scientific Orals: Otology and Neurotology

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

Sunday, September 29, 2024
3:12 PM – 3:18 PM EDT
Location: MBCC, 222
Disclosure(s):
Emily R. Youner, MD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Introduction: Cochlear implants (CI) are an effective and safe treatment for patients with severe to profound hearing loss. Studies have shown that cochlear implantation increases the incidence of bacterial meningitis. Most post-CI meningitis cases are due to pneumococcal meningitis. However, studies have yet to demonstrate an association between pneumococcal vaccination and a decreased risk of meningitis amongst cochlear implant recipients.

Methods: A retrospective cohort study was conducted utilizing the TriNetx Analytics Network, a large database of de-identified electronic health record data of over 78 million patients across the United States and 127 million patients worldwide. This database was queried for patients of all ages who had received cochlear implantation. Patients were then split into two cohorts based on their vaccination status. Patients in the vaccinated group had RxNorm or CPT coding specific to Pneumococcal Conjugate Vaccine (PCV) serotypes 15, 20, or 23. Patients in the under-vaccinated group had an ICD-10 code that identified under-immunization. The primary outcome measure was the occurrence of bacterial meningitis following cochlear implantation.

Results: In total, 35,434 patients received a cochlear implant. Of these, 9,024 patients had coding sufficient to assess their immunization status and were included. Of those included, 8,456 (93.7%) had evidence of PCV immunization, while 568 (6.3%) were found to be under-immunized. Overall, 234 patients (2.6%) had an episode of meningitis after cochlear implantation. The vaccinated group demonstrated a significantly lower incidence of meningitis (2.5%, n = 212) compared to the under-vaccinated group (3.9%, n = 22) (OR: 1.57; CI: (1.0016, 2.4512); p < 0.0492).

Conclusions: 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.

    Presenting Author(s)

  • JH

    Jamil Hayden, MD

    Department of Otolaryngology-Head and Neck Surgery, University Hospitals Cleveland Medical Center, United States

    Disclosure information not submitted.

    • Co-Author(s)

  • CC

    Chelsea N. Cleveland, MD

    Resident
    Department of Otolaryngology-Head and Neck Surgery, University Hospitals Cleveland Medical Center
    Cleveland, Ohio, United States

    Disclosure information not submitted.

  • De'Andre A. Warren, MD

    Resident Physician
    University Hospitals Cleveland Medical Center
    Cleveland, OH, United States

    Disclosure information not submitted.

    • Presenting Author(s)

  • Emily R. Youner, MD

    Resident
    Case Western Reserve University/ University Hospital Case Medical Center
    Cleveland, OH, United States

    Disclosure(s):

    faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

    • Co-Author(s)

  • Emily R. Youner, MD

    Resident
    Case Western Reserve University/ University Hospital Case Medical Center
    Cleveland, OH, United States

    Disclosure(s):

    faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

    • Senior Author(s)

  • TO

    Todd D. Otteson, MD, MPH

    Chief, Pediatric Otolaryngology
    Department of Otolaryngology-Head and Neck Surgery, University Hospitals Cleveland Medical Center
    Cleveland, OH, United States

    Disclosure information not submitted.

  • Maroun T. Semaan, MD

    Professor
    Case Western Reserve University Medical School/University Hospitals
    Cleveland, Ohio, United States

    Disclosure information not submitted.