A quality improvement study: Optimizing pneumococcal vaccination rates in children with cochlear implants.

Area of Science:

• Pediatric Otolaryngology
• Infectious Diseases
• Vaccinology

Background:

• Children with cochlear implants face a higher risk of invasive pneumococcal disease.
• Guidelines recommend additional pneumococcal vaccines for these children.
• Immunization status in this group is often suboptimal.

Purpose of the Study:

• To assess pneumococcal immunization status and invasive pneumococcal disease rates in children with cochlear implants.
• To evaluate the impact of vaccination reminders and a dedicated immunization clinic on vaccination rates.
• To identify strategies for improving vaccine uptake in medically-at-risk pediatric populations.

Main Methods:

• Quality improvement study over 12 years at a tertiary pediatric hospital.
• Included 200 children with cochlear implants.
• Assessed impact of electronic reminders and a nurse-led immunization clinic.

Main Results:

• 88% of children were not up-to-date with recommended pneumococcal vaccines.
• 2% of children developed invasive pneumococcal disease.
• Electronic reminders increased vaccine uptake from 12% to 49%.
• Dedicated clinic achieved 100% uptake for Prevenar13 and 81% for Pneumovax23.

Conclusions:

• A significant proportion of children with cochlear implants remain under-vaccinated against pneumococcal disease.
• Interventions like electronic reminders and dedicated clinics are effective in improving vaccine uptake.
• The demonstrated model can be expanded to other at-risk pediatric groups.