Vaccines and Kidney Disease

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. 

What is a vaccine?

Vaccines are a standard part of preventative medical care, which is medical care that helps prevent sickness or injury.  Vaccines work by using parts of bacteria or a virus to "fake" an infection. When these bacteria and virus parts 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 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.  

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. You can read more about the latest information from the CDC on COVID-19 vaccines for moderately to severely immunocompromised people. 

The Pfizer, Novavax, and Moderna vaccines have all been approved and authorized by the FDA in the United States. If you are not already vaccinated, you can work with your pharmacy to get the first 2-3 doses, which should come from the same brand. If you have been vaccinated previously, you should still get the latest COVID-19 vaccine. Updated vaccines keep your immunity high and work better against current strains of COVID-19. 

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

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 doctor that can help you stay healthy.  

• Respiratory syncytial virus (RSV) vaccine: The RSV vaccine is now recommended for adults 50 and older, especially those with underlying conditions such as heart disease, diabetes, or kidney disease. The virus often causes cold-like symptoms but can lead to serious illness, including pneumonia. The vaccine helps lower the risk of severe infection and hospitalization. Learn more.
• Pneumococcal vaccine: This vaccine is recommended for all adults 50 and older. It protects against pneumococcal disease, which can cause serious and potentially life-threatening conditions such as pneumonia and meningitis. Learn more.
• Pneumonia 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 doctor 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

It is possible to receive multiple vaccinations at the same time, for example your COVID-19 and flu shots. Getting these vaccines at the same time means you only need to visit your doctor once. Talk to your doctor about scheduling multiple vaccines in the same appointment. They can give you guidance on best practices for vaccines and what to expect if you are getting multiple shots. 

Respiratory illness season (also known as Flu season) usually starts in the fall and peaks in the winter. The CDC recommends that everyone 6 months and older gets vaccinated for the flu by the end of the October. Getting the most recent COVID-19 vaccine by the end of October can also protect you against the increase in infections that usually occurs from November to January. Talk to your doctor about the best time for you to get these seasonal vaccines.  

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 previously received COVID-19 vaccines, make sure you get the most recent vaccine. Talk to your doctors if you have any questions about your vaccine status.  

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 doctor 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.