title: Vaccine administration in children with chronic kidney disease.
abstract: Pediatric patients with severe chronic kidney disease (CKD) on conservative treatment, on dialysis, and those with renal transplantation are at a higher risk for infectious diseases as the result of impaired immune responses against infectious agents. Infections in these patients can have drastic consequences for disease morbidity and mortality. Immunization is a crucial preventive strategy for disease management in this pediatric population. However, vaccination coverage among children with CKD remains low due to safety concerns and doubts about vaccine immunogenicity and efficacy. In this study, we reviewed why children with CKD are at higher risk of infections, the importance of vaccinations among these children, barriers to vaccinations, and recommend the best vaccination schedules. Overall, vaccines have acceptable immunogenicity, efficacy, and safety profiles in children with CKD. However, in some cases, the protective antibody levels induced by vaccines and the benefits and risks of booster vaccine doses must be individually managed. Furthermore, close contacts and household members of these children should complete age-appropriate vaccination schedules to increase the child's indirect protection.
authors.affiliation: Pediatric Highly Intensive Care Unit, Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Via Commenda 9 20122, Milano, Italy. susanna.esposito@unimi.it
authors.forename: Susanna
authors.initials: S
authors.lastname: Esposito
authors.forename: Maria Vincenza
authors.initials: MV
authors.lastname: Mastrolia
authors.forename: Elisabetta
authors.initials: E
authors.lastname: Prada
authors.forename: Carlo
authors.initials: C
authors.lastname: Pietrasanta
authors.forename: Nicola
authors.initials: N
authors.lastname: Principi
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003141:Communicable Diseases / Q000453:epidemiology / Q000276:immunology*; D006801:Humans; D007115:Immunization Schedule; D007223:Infant; D006435:Renal Dialysis; D051436:Renal Insufficiency, Chronic / Q000150:complications / Q000276:immunology* / Q000628:therapy*; D014611:Vaccination / Q000009:adverse effects / Q000379:methods*; D014612:Vaccines / Q000008:administration & dosage* / Q000009:adverse effects / Q000276:immunology*
chemical_list: D014612:Vaccines