Vaccine recommendations for patients on chronic dialysis. The Advisory Committee on Immunization Practices and the American Academy of Pediatrics.
Pediatric patients on dialysis should receive all the vaccines currently recommended by the ACIP and the AAP for healthy children, except the oral polio vaccine (34, 35). Adult patients should receive the hepatitis B vaccine series, pneumococcal vaccine, yearly influenza vaccinations, tetanus-diphtheria toxoids, and varicella vaccine, if they are susceptible (33, 48, 69). Vaccines are well tolerated by these patients (33), but higher doses and/or additional boosters may be required periodically to adequately protect dialysis patients from vaccine-preventable diseases (33, 36, 37, 82, 83). Following vaccination, antibody concentrations for hepatitis B vaccine should be measured annually and booster doses administered when antibody concentrations fall below protective levels (33, 38). Although both children and adults on dialysis may show an impaired and/or delayed immunologic response to certain antigens, particularly hepatitis B virus and S. pneumoniae, appropriate immunizations can significantly reduce the risk of serious complications from vaccine-preventable diseases (11, 84). Because the protection these vaccines provide may be incomplete or transient, infection control strategies at hospitals and other health care facilities should be implemented simultaneously. Health care providers are encouraged to assess each patients need for vaccinations individually and formulate immunization strategies early in the course of progressive renal disease, ideally before the patient requires dialysis.
Rangel
M C
MC
Adult Vaccine Preventable Diseases Branch, Centers for Disease Control and Prevention, Atlanta, Georgia 30333, USA. mnr7@cdc.gov
Coronado
V G
VG
Euler
G L
GL
Strikas
R A
RA
D001428:Bacterial Vaccines; D019433:Chickenpox Vaccine; D022362:Hepatitis A Vaccines; D017325:Hepatitis B Vaccines; D006801:Humans; D007252:Influenza Vaccines; D022242:Pneumococcal Vaccines; D011054:Poliovirus Vaccine, Inactivated; D006435:Renal Dialysis; D013296:Streptococcus pneumoniae; D015164:Vaccines, Inactivated; D014761:Viral Hepatitis Vaccines; D014765:Viral Vaccines
D001428:Bacterial Vaccines; D019433:Chickenpox Vaccine; D022362:Hepatitis A Vaccines; D017325:Hepatitis B Vaccines; D007252:Influenza Vaccines; D022242:Pneumococcal Vaccines; D011054:Poliovirus Vaccine, Inactivated; D015164:Vaccines, Inactivated; D014761:Viral Hepatitis Vaccines; D014765:Viral Vaccines