Influenza immunization in patients with chronic renal disease

Patients receiving long-term hemodialysis (23) and patients with moderate to severe renal impairment and without hemodialysis (14) were immunized with inactivated influenza A/New Jersey/76 whole virus vaccine. Fourfold or greater increases in hemagglutinating-inhibiting antibody (HAI) titers occurred in 94% of controls, 93% of nondialyzed patients with chronic renal disease, and 87% of patients with continual hemodialysis. Postimmunization geometric mean titers in both groups of patients were equivalent to those of controls. The proportion of patients responding to vaccine was independent of levels of creatinine clearance, and the presence of preimmunization HAI titers also had no effect on frequency of seroconversion. Though some element of immunologic suppression is associated with chronic renal disease, it is not reflected in the humoral antibody response to influenza A/New Jersey/76 vaccine.