Influenza vaccination in patients with chronic renal failure

27 patients with chronic renal failure (CRF), 12 of whom were on maintenance hemodialysis, and 40 healthy control individuals were immunized with a split-type influenza vaccine containing A/Victoria/75 (H3N2), A/USSR/77 (H1N1), B/Hong Kong/73 antigens; 2 doses were given 4 weeks apart. Antibody responses were determined by the single radial hemolysis (SRH) technique. After immunization a significant rise (increase in SRH greater than or equal to 2 mm) was measured to A/Victoria in 11 (73%) azotemic and in 11 (92%) hemodialyzed patients and in 35 (88%) controls. To B/Hong Kong a significant antibody rise was observed in 10 (67%) azotemic, in 11 (92%) hemodialyzed and in 27 (68%) control individuals. The mean prevaccination and postvaccination antibody titers in patients with CRF, either azotemic or hemodialyzed, were significantly lower than in healthy control individuals to both A/Victoria and B/Hong Kong antigens (p less than 0.001). On the other hand the mean antibody rises after vaccination were of the same magnitude in all groups. The patients on maintenance hemodialysis had lower prevaccination antibody titers but the postvaccination mean titers were slightly higher than in the azotemic patients. No adverse reactions to the vaccination or deterioration of the renal function were observed; thus we recommend an annual vaccination of patients with CRF.