Safety and Effectiveness of a 2009 H1N1 Vaccine in Chronic Kidney Disease Children

Abstract

Background/Aims: Influenza vaccination is the most effective method for preventing influenza infection and its complications. The risk groups are children with chronic kidney diseases (CKDs) such as children on peritoneal dialysis (PD) and hemodialysis (HD), predialysis CKD (pCKD) and renal transplant (RTx) patients and immunosuppressed children. The aim of the present study was to assess the safety and immunogenicity of a single administration of a monovalent inactivated pandemic (H1N1) 2009 vaccine in children with CKD. Methods: Patients were given a single intramuscular injection of 0.5 ml of monovalent inactivated vaccine. Results: Totally, there were 25 pediatric patients with a diagnosis of CKD (16 PD, 2 HD, 3 pCKD and 4 RTx). Seroconversion was observed in 15 of the 16 patients with PD. Seroconversion occurred in all patients undergoing pCKD and HD. However, 3 of the RTx patients were seronegative. Conclusion: This study demonstrated a high level of immunogenicity and safety of an (H1N1) 2009 influenza vaccine in children with CKD.

Influenza vaccination in patients with end-stage renal disease

“…Satisfactory results were obtained only in studies in which few children were enrolled and in which no control group of healthy subjects was included [71,72]. Gavald a et al [71] and Donmez et al [72] studied 17 KT children and 25 pediatric patients on HD or PD who received a dose of an adjuvanted vaccine and a dose of non-adjuvanted vaccine, respectively. In both cases, the seroconversion and seroprotection rates were considered adequate, although some children, particularly those with KT, did not develop protective titers.…”

Vaccination Practices in Pediatric Dialysis Patients Across Europe. A European Pediatric Dialysis Working Group and European Society for Pediatric Nephrology Dialysis Working Group Study

“…Children on dialysis, with chronic kidney disease (CKD) stages 2–5 and those with renal transplants (RTx) are at increased risk for vaccine-preventable infections, which are significant causes of morbidity and mortality [3-6]. These patients are vulnerable to infections because of the alterations in humoral and cellular immune response, which are adversely affected by uremic toxins, malnutrition, and immunosuppressive medications [7, 8]. Children with CKD should receive all the recommended childhood immunizations according to the standard schedule whenever possible [3].…”