High-dose influenza vaccine lowers hospitalization rates in dialysis patients

A new study published in the Clinical Journal of the American Society of Nephrology (CJASN) reports that receipt of high-dose compared with standard dose influenza vaccine was associated with lower rates of hospitalization in kidney failure patients on dialysis.

Dana C. Miskulin and associates conducted a study to find out whether the high-dose influenza vaccine benefits patients on dialysis, whose immune response to vaccination is less robust than that of healthy patients.

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The investigators compared hospitalizations and deaths during the 2015-16 and 2016-17 influenza seasons by vaccine type (standard trivalent, standard quadrivalent, and high-dose trivalent influenza vaccine) administered to more than 9000 patients in season within a national dialysis organization.

The study found that receiving high-dose vs. standard dose influenza vaccine in 2016-17 was associated with lower rates of hospitalization in dialysis patients, although this association was not seen in 2015-16. There were no differences in rates of death between patients receiving the high-dose vs. standard dose influenza vaccine during either influenza season.

"We found that the administration of the high-dose influenza vaccine was associated with 8% fewer first hospitalizations than the standard dose vaccine in 2016-17. In 2015-16 there was no difference by vaccine type although statistical power was limited, with only 8% of patients receiving a high dose that year, compared with 61% in 2016-17," said Dr. Miskulin.

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According to the authors, these results should not be considered definitive, because vaccine type was not randomized but they suggest that there may be a reduction in influenza-related morbidity in dialysis patients with use of the high-dose vs. standard dose vaccine.

High-dose influenza vaccine, which contains fourfold more antigen than the standard dose, is linked with fewer cases of influenza and less severe influenza symptoms in the elderly general population.

For reference log on to https://doi.org/10.2215/CJN.03390318