What vaccines are recommended for CKD patients, especially those with advanced CKD or on dialysis?

• A. Influenza vaccine annually; pneumococcal vaccines; hepatitis B as indicated
• B. Influenza vaccine annually only
• C. Pneumococcal vaccines only
• D. Influenza vaccine annually; pneumococcal vaccines; hepatitis B as indicated; consider COVID-19 vaccination

Answer: (D)

People with chronic kidney disease, especially in advanced stages or on dialysis, have impaired immune function and are at higher risk for severe infections. Vaccination in this group aims to prevent the infections most likely to cause serious complications. The influenza shot each year reduces flu-related illness and hospitalization; pneumococcal vaccination protects against pneumonia and invasive disease that CKD patients are more prone to; hepatitis B vaccination should be given if the patient is not already immune due to the dialysis setting and exposure risk; and COVID-19 vaccination should be considered because CKD patients face higher risk of severe illness from SARS-CoV-2, with boosters as recommended. This combination provides broad protection for a population particularly vulnerable to infectious complications.