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Published on: March 24, 2023
Documenting immunization of children in a cochlear implant program
Peter G Volsky1, Daniel A Ballard, Stephanie Moody-Antonio
1*Department of Otolaryngology-Head and Neck Surgery, †Eastern Virginia Medical School, Norfolk, Virginia, U.S.A.
Insights
Implementing an immunization verification protocol (IVP) significantly improved pneumococcal vaccination rates in pediatric cochlear implant patients. Requiring immunization documentation before surgery showed the highest compliance.
Area of Science:
- Otolaryngology
- Pediatric Health
- Immunology
Background:
- Cochlear implantation requires specific immunizations, including pneumococcal vaccines.
- Achieving and documenting these vaccinations can be challenging in pediatric cochlear implant programs.
Purpose of the Study:
- To assess the effectiveness of an immunization verification protocol (IVP) in achieving and documenting pneumococcal vaccination for pediatric cochlear implant patients.
Main Methods:
- A chart review was conducted at an academic tertiary medical center.
- The study included 76 pediatric patients with cochlear implants.
- Outcomes measured included immunization status before and after IVP implementation, final immunization numbers, and communication effectiveness.
Main Results:
- After IVP initiation, full pneumococcal immunization in pre-IVP patients increased from 2% to 63%.
- For patients implanted after IVP initiation, 56% were vaccinated at surgery, and 94% were vaccinated by study conclusion.
- Overall, 70% of children had complete immunization documentation.
Conclusions:
- Achieving and documenting recommended immunizations for cochlear implant patients is challenging.
- Requiring pre-surgical immunization documentation led to the highest compliance rates.
- Access to vaccination registries and in-office vaccination administration improved compliance.
Purpose:
Assess the effectiveness of an immunization verification protocol (IVP) to achieve and document pneumococcal vaccination of patients with cochlear implants.
Study Design:
Chart review.
Setting:
Academic tertiary medical center.
Patients:
Pediatric patients with cochlear implants (n = 76).
Outcome Measures:
1) Status of pneumococcal immunization for cochlear implant patients, before and after initiation of the IVP; 2) final number of existing cochlear implant patients successfully immunized after institution of the IVP; and 3) effectiveness of communication between our office and patient/parent or pediatrician.
Results:
Subjects were grouped according to whether their cochlear implantation was performed before (Group 1, n = 63) or after (Group 2, n = 18) initiation of the IVP in September 2010. In the 28 months between IVP initiation and January 2013, the number of fully immunized age-eligible patients increased in Group 1 from 2% (n = 1) to 63% (n = 40). Of 18 subjects in Group 2, 56% (n = 10) were fully vaccinated at the time of surgery, and 94% were fully vaccinated at the conclusion of the study (n = 17). Of all 81 children, complete immunization was documented in 70% (n = 57), incomplete documentation was noted in 16% (n = 13); and 14% (n = 11) were lost to follow-up.
Conclusion:
It is a challenge to achieve and document immunizations recommended for cochlear implantation, even in a relatively small cochlear implant program. In our practice, those patients who were required to document immunizations before surgery had the highest rates of compliance. Access to a vaccination registry and the ability to administer vaccines in the otolaryngology office also improved compliance.
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