Active influenza immunization in hemodialysis patients: comparison between single-dose and booster vaccination

Hemodialysis (HD) patients are recommended to be immunized against influenza annually, but the immune response after vaccination is known to be weakened in these patients. We intended to compare the efficacy of influenza vaccines in HD patients with that in healthy people, and we also evaluated the additive effect of a booster vaccination in HD patients.

During the 2003-2004 influenza season, 100 patients on HD and 50 age-matched healthy controls were recruited from the Korea University Guro Hospital. The HD patients were divided into two groups: single-dose group (50 patients) and booster group (50 patients). Eight weeks following the influenza vaccination, the serum antibody responses were compared.

Although the antibody response of the HD patients was impaired in comparison with that of healthy controls, more than 90% of the HD patients showed protective antibody levels. Booster vaccination did not significantly increase the immune response in HD patients.

Influenza vaccination in HD patients should be encouraged, but the immune response was comparatively impaired in subpopulations, including patients with a long-term HD history (>2.5 years), with a higher urea reduction rate, or with underlying diabetes. There was no effect of a booster vaccine dose on the antibody titers.