Abstract Patients with chronic kidney disease (CKD), especially those on dialysis, are at high risk of infections leading to hospitalizations, morbidity, and mortality. Influenza, pneumococcal pneumonia, and respiratory syncytial virus (RSV) infections account for a significant proportion of typical infectious complications and are preventable by vaccination. The immune system is weakened in CKD, reducing vaccination efficacy. Additionally, some patients with CKD receive immunosuppressive medications. The reduced seroreactivity to various vaccines must be considered when selecting vaccines, vaccine doses, and schedules for patients with CKD. Vaccinations are generally safe in CKD and should be widely used according to public health recommendations to reduce morbidity. Immunosuppression after kidney transplantation further impairs vaccination responses. Nevertheless, vaccinations can still be effective and provide protection in a relevant number of patients. Post-transplant patients should generally not receive live vaccines due to the risk of vaccine-induced complications. Vaccination is usually recommended 6 months after transplantation, as immunosuppression is less intense than in the early months. This approach may conflict with seasonal vaccinations, which are often omitted. Data show that at least the influenza vaccination can be administered as early as 4 weeks after transplantation without additional risk. In all patients with CKD or post transplant, omitting recommended vaccinations is a missed opportunity for preventing relevant infectious complications.
Silke Markau (Sun,) studied this question.