Effectiveness of influenza vaccine in patients on hemodialysis - A review

Department of Family Medicine, Wrocław Medical University, Wrocław, Poland and Public Higher Professional Medical School, Opole, Poland.
Medical science monitor: international medical journal of experimental and clinical research (Impact Factor: 1.43). 11/2013; 19:1013-8. DOI: 10.12659/MSM.889671
Source: PubMed


The influenza virus is one of the most common causes of viral respiratory tract infections. Some chronic diseases predispose to a severe course of the disease and increase the risk of complications and death. To minimize the risk of infection and complications, care of patients with increased risk should include prophylactic measures such as the administration of a seasonal influenza vaccine. An influenza vaccine is the best and cheapest method of influenza prevention. It is indicated for patients with chronic kidney disease, both during conservative treatment and renal replacement therapy.
Many studies that have assessed the efficacy of an influenza vaccine in patients on hemodialysis have found that immune deficiency predisposes these patients to infection and a severe course of the disease. Because the immune response to a standard influenza vaccine in this population is weak, the studies covered many aspects of vaccination, including the need for a booster dose.
Unlike in a healthy population, the efficacy of an influenza vaccine in patients on hemodialysis might be insufficient; however, the vaccine is still able to induce immunity in a significant number of patients. Considering the latest data and the results of studies described above, the recommendation of a seasonal influenza vaccine should be obligatory in all hemodialysis patients.
This paper is based on original articles available from Medline database. The most recent and most significant literature on the influenza vaccine in patients on hemodialysis has been reviewed.

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Available from: Agnieszka Mastalerz-Migas, Apr 15, 2014
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    ABSTRACT: Influenza, caused by the influenza virus, is a respiratory infectious disease that can severely affect human health. Influenza viruses undergo frequent antigenic changes, thus could spread quickly. Influenza causes seasonal epidemics and outbreaks in public gatherings such as schools, kindergartens, and nursing homes. Certain populations are at risk for severe illness from influenza, including pregnant women, young children, the elderly, and people in any ages with certain chronic diseases. To strengthen the technical guidance for control and prevention of influenza, and to promote influenza vaccination in China, the Chinese Center for Disease Control and Prevention organized a panel of experts to review the latest international studies on influenza vaccination, including the "WHO Position Paper on Influenza Vaccines - November 2012", and to compile the "Technical Guidelines for the Application of Seasonal Influenza Vaccines in China (2014-2015)". The guidelines systematically review the published literatures and unpublished works from the latest influenza research in China, including its etiology, clinical characteristics, laboratory diagnosis, epidemiology, disease burden, types of influenza vaccines, immune response mechanisms, durability of immunity, immunogenicity, vaccine efficacy, effectiveness, safety, cost-effectiveness and cost-benefit. On the basis of existing scientific evidence, the guidelines provide recommendations for influenza vaccination in the influenza season of 2014-2015. In China, influenza vaccine is not incliuded in the national immunization program, and recipients shall pay for the vaccine voluntarily out of pocket. Points of Vaccination clinics (POVs) should provide immunization services for all individuals aged six months and above who are willing to be vaccinated and have no contraindications. To decrease the risk of severe complications due to influenza infection, the guidelines recommend annual seasonal influenza vaccines to be administered to pregnant women, children aged 6-59 months, adults ≥60 years of age, persons with specific chronic diseases, healthcare workers, and family members and caregivers of infants <6 months of age. The guidelines can be used by staff of the Centers for Disease Control and Prevention at all levels who engage in influenza control and prevention, POVs staff, healthcare workers in the departments of pediatrics, internal medicine, and infectious diseases in medical institutions, and the staff of maternal and child health institutions. The guidelines will be updated periodically as new evidence becomes available.
    Full-text · Article · Dec 2014 · Human Vaccines & Immunotherapeutics