CKD and Vaccination

Vaccines are the most effective shield against a wide range of diseases ranging from common infections (such as flu) to severe life-threatening diseases (tetanus, pneumococcal pneumonia).

  • I am on dialysis. Do I need to vaccinate?
  • Some individuals belong to the high-risk groups (meaning they are more likely to get sick), and chronic kidney disease patients that undergo or not hemodialysis belong to this group. Therefore, vaccination for these patients is very important.
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  • Is it safe for a CKD patient to vaccinate?
  • It is one of the safest ways to treat infections and the most effective way to protect someone from serious infections. Of course, like any other drug, vaccines can have some side effects. These may vary from local skin irritation at the site of the shot or fever. The "risk" of administering the vaccines is far less than the immense risk of infections.
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  • Are there any CKD patients who should not take a vaccine?
  • Yes, the ones that have allergies to vaccines. Transplant recipients or those taking immunosuppression drugs for kidney disease should avoid some types of vaccinations, especially those from attenuated living microorganisms, i.e. the vaccine for herpes zoster is forbidden and cannot be given to a patient with immunosuppression. You should consult your doctor first.
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  • I am a kidney transplant patient. Can I do all the vaccines?
  • Kidney transplant patients, due to the reduced activity of their defense system, should avoid some vaccines containing live but attenuated microorganisms. Many of these contain viruses that have developed under conditions that inactivate their properties or use related but less dangerous micro-organisms to cause a broad immune response. Examples of such vaccines are vaccines for measles, rubella, mumps and herpes zoster.
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  • How often should I vaccinate myself?
  • It depends on each vaccine. Some must be done annually, whereas others once in a patient's life. There are also vaccines that may require one or more booster injections.
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  • What are the vaccines that I must do as a kidney patient?
  • The key vaccines are:
  • -The influenza vaccine on an annual basis.
  • -The pneumococcal conjugate vaccine (PCV13) and pneumococcal polysaccharide vaccine (PPSV23).
  • -People aged ≥19-64 years:
  • • It is recommended to get PCV13 first and ≥8 weeks later the PPSV23 vaccine.
  • • If PPSV23 is preceded, PCV13 is recommended at least 1 year later.
  • • The second dose of PPSV23 is recommended after ≥5 years from the previous PPSV23.
  • • If 2 doses of PPSV23 have been given then 1 dose of PCV13 ≥ 1 year after the second dose of PPSV23 is recommended.
  • -People aged ≥65 years:
  • • If they have not been vaccinated with PCV13 or PPSV23 or if the vaccination history is unknown, it is recommended that PCV13 is first performed and then PPSV23 vaccine after 6-12 months.
  • • If they have not been vaccinated with PCV13 and have received a dose of PPSV23 at age ≥ 65 years, a dose of PCV13 ≥1 years after PPSV23 is recommended.
  • • If they have not been vaccinated with PCV13 and have received ≥ 1 PPSV23 at the age of ≥19-64 years, it is recommended that a dose of PCV13 is taken after ≥1 year of the PPSV23 vaccine and a second dose of PPSV23 is recommended after 6-12 months after PCV13 vaccine and ≥5 years after the PPSV23 vaccine.
  • • If vaccinated with PCV13 and not with PPSV23 at the age of ≥19-64 years, it is recommended that a dose of PPSV23 is given after 6-12 months.
  • • If they have been vaccinated with PCV13 and then ≥1 with PPSV23 vaccine at the age of ≥19-64 years, it is recommended that a dose of PPSV23 is given 5 years after the first dose of PPSV23.
  • -The hepatitis B vaccine
  • Patients on dialysis or immunosuppression should be vaccinated with an increased dose of antigen of 40 mcg / ml per dose, a total of 3 doses (0, 1, and 6 months) or 4 doses (0, 1, 2, and 6 months) of the manufacturer.
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  • Mesogeios Dialysis Centers Group Scientific Team 
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  • Bibliography
  • 1.Abraham G, Ghosh S. Role of Pneumococcal Vaccination in Renal Diseases. J Assoc Physicians India. 2015 Apr;63(4 Suppl):36-7. Review. PubMed PMID: 26562964.
  • 2.Bitsori M, Galanakis E. Vaccine-preventable infection morbidity of patients with chronic kidney disease and cocoon vaccination strategies. Expert Rev Vaccines. 2015;14(10):1385-95. doi: 10.1586/14760584.2015.1075397. Epub 2015 Aug
  • 3.Review. PubMed PMID: 26289972.3: Yousaf F, Gandham S, Galler M, Spinowitz B, Charytan C. Systematic review of the efficacy and safety of intradermal versus intramuscular hepatitis B vaccination in end-stage renal disease population unresponsive to primary vaccination series. Ren Fail. 2015 Aug;37(7):1080-8. Epub 2015 Aug 10. Review.PubMed PMID: 26258528.
  • 4.Grzegorzewska AE. Prophylactic vaccinations in chronic kidney disease: Current status. Hum Vaccin Immunother. 2015;11(11):2599-605. doi:10.1080/21645515.2015.1034915. Epub 2015 Apr 27. Review. PubMed PMID: 25911956;PubMed Central PMCID: PMC4685704.
  • 5.Kapoian T, Meyer KB, Johnson DS. Infection prevention and the medical director: uncharted territory. Clin J Am Soc Nephrol. 2015 May 7;10(5):863-74.doi: 10.2215/CJN.06050614. Epub 2015 Feb 20. Review. PubMed PMID: 25710803; PubMed Central PMCID: PMC4422234.
  • 6.Remschmidt C, Wichmann O, Harder T. Influenza vaccination in patients with end-stage renal disease: systematic review and assessment of quality of evidence related to vaccine efficacy, effectiveness, and safety. BMC Med. 2014 Dec 19; 12:244. doi: 10.1186/s12916-014-0244-9. Review. PubMed PMID: 25523432; PubMed Central PMCID: PMC4298993.
  • 7.Eleftheriadis T, Pissas G, Antoniadi G, Liakopoulos V, Stefanidis I. Factors affecting effectiveness of vaccination against hepatitis B virus in hemodialysis patients. World J Gastroenterol. 2014 Sep 14;20(34):12018-25. doi:10.3748/wjg. v20.i34.12018. Review. PubMed PMID: 25232238; PubMed Central PMCID: PMC4161789.
  • 8.Edey M, Barraclough K, Johnson DW. Review article: Hepatitis B and dialysis Nephrology (Carlton). 2010 Mar;15(2):137-45. Doi:10.1111/j.1440-1797.2009.01268. x. Review. PubMedPMID: 20470270.
  • 9.National vaccination program: Vaccines for adults in high – risk groups.
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