Influenza immunization in hemodialyzed or kidney transplanted adolescents and young adults

Abstract

Aim: To clarify the immunogenicity and safety of influenza vaccine in patients with end-stage kidney disease (ESKD) on dialysis or who have received a kidney transplant. Methods: Sixty adolescents and young adults with ESKD (25 on hemodialysis and 35 kidney transplant recipients) were randomized 1:1 to receive a traditional trivalent split virion vaccine (TIIV) or a virosome-adjuvanted trivalent inactivated influenza vaccine (VATIIV). The immunogenicity and safety of the two vaccines was evaluated and compared with the findings observed in 30 healthy subjects of similar age and gender distribution who received TIIV. Results: The results indicate that the immune response of the patients to TIIV and VATIIV were similar. The administered vaccines were safe and well tolerated, and no advantage was found with the use of VATIIV. Conclusion: Given the potential clinical relevance of influenza in patients with ESKD, these findings support the official recommendation that they should receive annual influenza vaccinations.

Keywords::

• chronic renal disease
• hemodialysis
• influenza vaccination
• kidney transplantation
• trivalent inactivated influenza vaccine
• virosomal-adjuvanted influenza vaccine

Financial & competing interests disclosure

This study was supported in part by a grant from the Italian Ministry of Health (Bando Giovani Ricercatori 2009). The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

No writing assistance was utilized in the production of this manuscript.

Key issues

• Patients with end-stage kidney disease (ESKD) generally experience excess influenza-related morbidity and mortality.

• Health authorities throughout the world include hemodialyzed patients and kidney transplant recipients among the subjects for whom annual influenza vaccination is strongly recommended.

• Influenza vaccination coverage among ESKD patients on hemodialysis and kidney transplant recipients is significantly less than it should be.

• Both trivalent split virion vaccine and virosomal-adjuvanted trivalent inactivated influenza vaccine are as immunogenic in hemodialyzed and transplanted adolescents and young adults as in healthy controls.

• Neither vaccine caused any significant adverse event, including early or late renal problems.

• Given the potential clinical relevance of influenza in ESKD patients, our findings support the official recommendation that they should receive annual influenza vaccination and indicate that every effort should be made to increase their influenza vaccination coverage.