28
Special Populations
118. Meningococcal vaccine should be administered to patients ≥2
months of age who are asplenic or have a sickle cell disease
(SR-L) as in recommendation 29 except that MCV4-D should not
be administered in patients age <2 years because of a reduced
antibody response to some pneumococcal serotypes when
both MCV4 and PCV are administered simultaneously (SR-L).
Revaccinate with MCV4 (or MPSV4 for those >55 years of age who
have not previously received MCV4) every 5 years (SR-L).
Anatomic Barrier Defects (Table 7)
119. Adults and children with profound deafness scheduled to
receive a cochlear implant, congenital dysplasias of the inner
ear, or persistent cerebrospinal fluid (CSF) communication
with the oropharynx or nasopharynx should receive all vaccines
recommended routinely for immunocompetent persons based on
the CDC annual schedule. None is contraindicated (SR-M) (Table 7).
120. Patients with a cochlear implant, with profound deafness who
are scheduled to receive a cochlear implant, or with persistent
communication between the CSF and oropharynx or nasopharynx
should receive PCV13 as described in the standard schedule for
children and recommendations 27a-c (SR-L to M).
121. Patients ≥24 months of age with a cochlear implant, with profound
deafness who are scheduled to receive a cochlear implant, or with
persistent communication between the CSF and oropharynx or
nasopharynx should receive PPSV23, preferably ≥8 weeks after
PCV13 (SR-M).
122. PCV13 and PPSV23 should be administered ≥2 weeks prior to
cochlear implant surgery, if feasible (SR-L).
