Vaccines and Kidney Disease

What is a vaccine?

Vaccines are a standard part of preventative medical care.  They use parts of bacteria or a virus to "fake" an infection. When these bacteria and viruses enter your body, an antibody will find it. Antibodies are proteins made by your immune system that find germs and help your body destroy them. The first time a person is exposed to a bacteria or virus, the immune system makes a specific antibody for that virus or bacteria.

Once your body has created antibodies from the parts of a bacteria or virus in the vaccine, these antibodies will stay in your body for a long time. This way, if that germ gets inside your body again, the antibodies will notice it quickly and destroy them. This can help prevent you from getting sick or developing severe sickness.  

Should I get vaccines if I have chronic kidney disease?

Vaccines are safe and essential for patients with kidney disease. They create an additional layer of protection against infectious diseases (or transferrable disease), which can prevent you from getting sick or from developing severe symptoms. Some examples of infectious (or transferrable) disease include influenza (flu), coronavirus (covid-19) or hepatitis (inflammation of the liver). 

According to the Centers for Disease Control and Prevention (CDC), all patients with kidney disease, people on dialysis, and kidney transplant recipients are immunocompromised. This means that your immune system does not work as well as it should, and you are at a higher risk for infectious diseases. Being immunocompromised means that vaccines are especially important to keep a healthy immune system.  

All vaccines that you receive at a pharmacy or from your doctor are approved by the food and drug administration (FDA). This means that they have been studied to make sure they work, and they are safe. 

Should I get the COVID-19 vaccine? 

As a patient with kidney disease, you are eligible to receive the COVID-19 vaccine. It is safe and recommended for patients at all stages of kidney disease, patients receiving dialysis, and transplant recipients.  

The Pfizer, Novavax, and Moderna vaccines have all been approved by the FDA. If you are not already vaccinated, you can receive 2-3 doses of the vaccine. If you have been vaccinated previously, you may be eligible to receive additional doses or boosters.  

No brand of COVID-19 vaccine is better than the others. It is recommended that all doses you receive are of the same brand. This means that if your first dose is from Pfizer, all your subsequent doses should be from Pfizer.  

Talk to your doctor or pharmacist about any questions or concerns you might have on vaccines. 

All patients with kidney disease are at higher risk for contracting COVID-19 and developing severe symptoms. Having an immunocompromised status means that you should receive as many COVID-19 doses as your doctor recommends.

Do I need a flu shot?  

The influenza or flu shot is a vaccine that you should receive annually. Patients with kidney disease are at a higher risk of developing serious flu complications, which can lead to being in the hospital and potentially death. Receiving an annual flu shot can reduce the risk of getting the flu, reduce flu symptoms and being hospitalized for the flu.  

The flu virus changes every year, and a new vaccine is developed to protect from the newest strains. This is why it is important to get vaccinated each year. It is ideal to get the flu shot by the end of October, as flu season runs from October to May. The earlier you get the shot, the earlier you will be protected against the flu. 

Patients with kidney disease, receiving dialysis, and kidney transplant recipients should only receive the intravenous vaccine (given with a needle). Nasal spray vaccines have not been proven safe or effective for patients with chronic kidney disease.

What other vaccines should I be aware of? 

COVID-19 and flu vaccines are both important for maintaining your health. There are also other vaccines that you should discuss with your healthcare provider that can help you stay healthy.  

• Respiratory syncytial virus (RSV) vaccine: Patients older than 60 with chronic kidney disease are at an increased risk for severe RSV and should receive the vaccine. RSV is a respiratory virus like COVID-19 and the flu. 
• Pneumonia or Pneumococcal Vaccine: Patients with chronic kidney disease should receive these vaccines to protect against pneumonia, meningitis, and other blood infections that can cause death.  
• Hepatitis B and TDAP (Tetanus, Diphtheria, and Pertussis) Vaccines: Ask your healthcare provider if you are up to date on these vaccines. If you are not, make a plan to become fully vaccinated.  

These are other vaccines you can ask your care team about, to learn if any are recommended for you: 

• Chickenpox 
• HPV (genital warts) 
• MMR (measles, mumps, and rubella) 
• Shingles

Can I receive vaccines if I am on dialysis?

Patients with kidney disease who receive dialysis have an increased risk for getting sick. If you receive dialysis in center, you are at a higher risk as you are exposed to more people. 

If you have received three doses of COVID-19 vaccine previously and are on dialysis, you are able to get a fourth dose.  

Dialysis patients who experience dehydration are at risk for more severe illness, as dehydration can make it difficult to fight off an infection. Work with your healthcare providers to manage fluid intake, particularly if you become sick.  

If you have an eGFR of <30 mL/min, you may be prescribed an antiviral medicine to treat COVID-19, which can reduce the risk of hospitalization and death. Your healthcare team will help decide if you should take this medicine, but it is always good to ask and see what your best options are.

Can I receive vaccines if I am a transplant recipient?

As a kidney transplant recipient, it is normal that you may have feelings of anxiety around getting sick and getting vaccines. Keeping your kidney healthy is a priority, and that means staying healthy! The good news is that vaccines are safe to receive and are an important part of maintaining your health.  

As a transplant recipient, you are on medicines called immunosuppressants. These prevent your body from rejecting your transplanted kidney. They also weaken your immune system, which makes you more susceptible to getting sick. Washing your hands, wearing a mask, and staying away from sick people are good practices to avoid getting sick.   

It's important to know that COVID-19 vaccines are not as effective for transplant patients, and so staying up to date with additional doses is key. There has been no evidence that acute rejection increases after a third vaccine dose, so it is safe to receive additional doses. As always, talk to your healthcare team about any questions or concerns you may have about getting vaccines or getting sick.

Resources to get more information and stay up to date on the latest vaccine guidance

Getting sick while having kidney disease can be scary. General practices such as handwashing, wearing masks, and avoiding sick people can help lower your chances of getting sick. Taking your medicines regularly and attending all your doctor's appointments is key to staying healthy.

Work with your healthcare team for any specific concerns or questions you may have.

There can be a lot of misinformation on vaccines and illness across the internet. Visit the CDC for the latest guidance on vaccines and considerations for patients with chronic kidney disease.  

• CDC Guidance on Flu, COVID-19, and RSV
• Flu and People with Chronic Kidney Disease