title: Efficacy of influenza A H1N1/2009 vaccine in hemodialysis and kidney transplant patients.
abstract: OBJECTIVE
  Data are needed to assess safety and efficacy of the 2009 pandemic influenza A H1N1 vaccine in renal patients.
  
  
  METHODS
  We prospectively evaluated seroconversion, predictors of response, and vaccine safety in renal patients. Hemagglutination inhibition tests to detect serum antibodies against a new influenza A-H1N1 virus were performed in 79 transplant patients, 48 hemodialysis patients, and 15 healthy workers before and 1 month after vaccination. Healthy controls and 88 of 127 renal patients were vaccinated. Seroconversion was defined as at least 2 dilutions increase in titer.
  
  
  RESULTS
  We excluded 19 individuals seroprotected (≥1/40) against the novel H1N1 in the initial sample. Efficacy rate in the 96 vaccinated individuals was 43.7% (42 of 96 seroconverted versus four of 27 nonvaccinated patients, P = 0.007). For vaccinated subgroups, efficacy was 41.8% in transplant patients (P = 0.039 versus nonvaccinated), 33.3% in hemodialysis patients (P = 0.450), and 81.8% in controls. Healthy controls showed better response to vaccine than transplant (P = 0.021) and dialysis (P = 0.012) patients. For the transplant subgroup, longer time after transplantation (P = 0.028) was associated with seroconversion, but no influence was found for age, gender, renal function, or immunosuppression. In the hemodialysis subgroup, younger age was associated with response (55.7 ± 20.8 versus 71.6 ± 10.1 years, P = 0.042), but other specific variables, including Kt/V or time on dialysis, were not. No serious adverse events were reported, and kidney function was stable.
  
  
  CONCLUSIONS
  The novel influenza A 2009 H1N1 vaccine was safe in renal patients, although administration of a single dose of adjuvanted vaccine induced a poor response in these patients.
authors.affiliation: Department of Nephrology, Parc de Salut Mar, Passeig Maritim 25-29, 08003 Barcelona, Spain. mcrespo@hospitaldelmar.cat
authors.forename: Marta
authors.initials: M
authors.lastname: Crespo
authors.forename: Silvia
authors.initials: S
authors.lastname: Collado
authors.forename: Marisa
authors.initials: M
authors.lastname: Mir
authors.forename: Higini
authors.initials: H
authors.lastname: Cao
authors.forename: Francesc
authors.initials: F
authors.lastname: Barbosa
authors.forename: Consol
authors.initials: C
authors.lastname: Serra
authors.forename: Carlota
authors.initials: C
authors.lastname: Hidalgo
authors.forename: Anna
authors.initials: A
authors.lastname: Faura
authors.forename: Milagros
authors.initials: M
authors.lastname: Montero
authors.forename: Juan
authors.initials: J
authors.lastname: García de Lomas
authors.forename: Juan P
authors.initials: JP
authors.lastname: Horcajada
authors.forename: Josep M
authors.initials: JM
authors.lastname: Puig
authors.forename: Julio
authors.initials: J
authors.lastname: Pascual
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D053118:Influenza A Virus, H1N1 Subtype / Q000276:immunology*; D007252:Influenza Vaccines / Q000276:immunology*; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D006435:Renal Dialysis; D013997:Time Factors; D014611:Vaccination
chemical_list: D007252:Influenza Vaccines