Vaccination in CKD and Kidney Transplant Recipients

Abstract

Infectious diseases are the second commonest cause of death in patients suffering from advanced chronic kidney disease (CKD) (1). Patients with CKD are vulnerable to vaccine-preventable infections (Hepatitis B & C, Herpes, H1N1, and community/hospital-acquired pneumonia’s) because of impaired immunity, immunosuppressive treatment and dialysis (2, 3). The recent COVID-19 infection has added to the woes of an already susceptible CKD and transplant population with higher morbidity and mortality in this group compared to the infection in the general population. It is without any argument that the pace at which vaccine/s has been developed to protect us from the ravaging pandemic of COVID-19 has been exemplary and will go a long way to decrease the morbidity and mortality, overall and specifically in the CKD and kidney transplant patients(4).

Though vaccination leads to reduced infection rates with a reduction in morbidity and mortality, there is a reduction in vaccine effectiveness across the stages of CKD due to multiple abnormalities in innate and adaptive immunity, leading to inadequate immune response (1). In addition, there are safety concerns for transplant recipients, especially with live attenuated vaccines. Therefore, it is recommended that vaccinations should be given in the early stages of CKD and preferably before kidney transplants (5).