Infections are a leading cause of morbidity (illness) and mortality (death) among patients at all stages of Chronic Kidney Disease (CKD). Vaccination is the best defense for those with CKD especially people who conduct dialysis to minimize the adverse consequences associated with infectious diseases such as hepatitis B virus (HBV), tetanus (whooping cough), pneumococcal (pneumonia), influenza (flu), and varicella-zoster virus (herpes).
Unfortunately, patients with End Stage Renal Disease (ESRD) have a reduced response to vaccinations because of the suppression of their immune system in general and specifically uremia (a condition in which the urine enters the bloodstream, instead of being eliminated from the body). Full immune-cell function is required to generate the most protective vaccine response. Little information exists concerning the effects of dialysis adequacy on the antibody (protein produced by the body's immune system) response to vaccination. There is, however, indirect evidence that increasing dialysis may be associated with an improved vaccine response.
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Despite the evidence of decreased effectiveness, current recommendations are for those with CKD to take their necessary vaccines. Early vaccination of high-risk viruses has demonstrated good health outcomes in the CKD and ESRD populations. In fact, studies have suggested that early vaccination may help to boost the immune system which will better protect those with ESRD against life threatening viruses.
The National Kidney Foundation recommends some vaccines to be taken as much as three times a year, such as HBV vaccines. While, in other cases, like the flu shot, vaccines are recommended only annually; and you are typically recommended to take the tetanus shot only once. However, in most cases, similar to pneumonia, you should ask your healthcare provider about the timing and spacing of your vaccinations.
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Roy Mathew, Darius Mason, and Jeffrey S Kennedy. "Expert Review of Vaccines." Vaccination Issues in Patients with Chronic Kidney Disease, , Informa Healthcare. Informa Plc.
Jean L Holley, MD, FACP Jeffrey S Berns, MD Alice M Sheridan, MD. "Immunizations in Patients with End-stage Renal Disease." Immunizations in Patients with End-stage Renal Disease. UpToDate.