Background: This study aims to assess whether Swiss guidelines for pneumococcal vaccination in children with cochlear implants are followed and whether they elicit adequate pneumococcal vaccine immunity.
Methods: We performed a retrospective analysis at the Western Switzerland University Cochlear Implants Center, reviewing data between January 2009 and December 2023. Vaccination records and serotype-specific pneumococcal IgG concentrations were extracted from computerized medical records.
Results: Fifty children were included, with a median implantation age of 1.5 years. In children <2 years old, 82% (27/33) were up to date with routine pneumococcal vaccination (3 doses of the 13-valent pneumococcal conjugate vaccine administered at 2, 4 and 12 months), yet only 56% (15/27) achieved protective pneumococcal seroprotection. In contrast, among children ≥2 years of age, 24% (4/17) received both the age-appropriate routine schedule and the additional recommended dose of 13-valent pneumococcal conjugate before implantation, and all of these (100%) showed protective seroprotection. An overall decline in seroprotection was observed within 5 years postvaccination, particularly around 5 years of age. Vaccine-induced immunity differed by serotype; serotypes 6B, 14 and 19 elicited higher antibody levels, whereas serotypes 4, 9V and 18C produced lower responses. Notably, children 2-5 years of age tended to exhibit lower overall pneumococcal immunity.
Conclusions: Our findings support the proactive administration of an additional pneumococcal vaccine dose at the time of planning cochlear implant surgery for children ≥2 years old. In addition, periodic monitoring of serotype-specific pneumococcal antibody levels (every 5 years) is recommended to determine the need for booster vaccinations.
Keywords: cochlear implants; pneumococcus; serology; vaccines.
Copyright © 2025 The Author(s). Published by Wolters Kluwer Health, Inc.