Shot talk: Which vaccines should you get if you or a loved one are living with kidney disease

As we enter the colder seasons when viruses spread more, now is the time to protect yourself against diseases – including COVID-19. This is especially true for people living with kidney disease. 

According to the Centers for Disease Control and Prevention (CDC), all people living with kidney disease, receiving dialysis treatments or living with a kidney transplant are immunocompromised. This means that your immune system does not work as well as it should, and you are at a higher risk for infectious diseases, like COVID-19, respiratory syncytial virus (RSV) or influenza (flu). Being immunocompromised means that vaccines are especially important for helping you maintain a healthy immune system. 

"Patients with kidney disease are at an increased risk of severe complications from COVID-19 and the flu," said Dr. Jamie A. Green, a nephrologist and chair of AKF's medical advisory committee. "The benefits of receiving these vaccines far outweigh the risks, as they can significantly reduce the likelihood of hospitalization and serious illness. We strongly encourage all patients with kidney disease to get vaccinated to protect their health."

Have questions about vaccines? The best thing you can do is talk to your doctor, but here are some answers to common questions to help you get started in protecting yourself this winter.

Should I get vaccines if I have chronic kidney disease?

Vaccines are safe and essential for patients with kidney disease. They create an additional layer of protection against infectious diseases (or transferrable disease), which can prevent you from getting sick or from developing severe symptoms. Some examples of infectious (or transferrable) disease include influenza (flu), coronavirus (COVID-19) or hepatitis (inflammation of the liver). 

What is a vaccine?

Vaccines are a standard part of preventative medical care, which is medical care that helps prevent sickness or injury.  Vaccines work by using parts of bacteria or a virus to "fake" an infection. When these bacteria and virus parts enter your body, an antibody will find it. Antibodies are proteins made by your immune system that find germs and help your body destroy them. The first time a person is exposed to a bacteria or virus, the immune system makes a specific antibody for that virus or bacteria.

Once your body has created antibodies from the parts of a bacteria or virus in the vaccine, these antibodies will stay in your body for a long time. This way, if that germ gets inside your body again, the antibodies will notice it quickly and destroy them. This can help prevent you from getting sick or developing severe sickness.  

Are vaccines safe?

All vaccines that you receive at a pharmacy or from your doctor are approved by the Food and Drug Administration (FDA). This means that they have been studied to make sure they work, and they are safe. 

Should I get the COVID-19 vaccine? 

Yes. As a patient with kidney disease, you are eligible to receive the COVID-19 vaccine. It is safe and recommended for patients at all stages of kidney disease, patients receiving dialysis, and transplant recipients.  

Should I get the flu vaccine?

Yes. The influenza or flu shot is a vaccine that you should receive annually. Patients with kidney disease are at a higher risk of developing serious flu complications, which can lead to being in the hospital and potentially death. Receiving an annual flu shot can reduce the risk of getting the flu, reduce flu symptoms and being hospitalized for the flu.

The flu virus changes every year, and a new vaccine is developed to protect from the newest strains. This is why it is important to get vaccinated each year. It is ideal to get the flu shot by the end of October, as flu season runs from October to May. The earlier you get the shot, the earlier you will be protected against the flu. 

Should I get the RSV vaccine?

It depends. Patients 60 and older with chronic kidney disease are at an increased risk for severe RSV and should receive the vaccine. RSV is a respiratory virus like COVID-19 and the flu. 

What other vaccines should I know about and make sure I'm up to date on?

You should ensure you are up to date on all routinely recommended vaccines for the general population. These include:

• Varicella (VAR or chickenpox) vaccine: This is recommended for children or for adults who have never had chickenpox or the vaccine.
• Tetanus, diphtheria and pertussis (TDAP) vaccine  —  Patients with kidney disease should receive vaccination with the tetanus, diphtheria and pertussis (Tdap) vaccine as recommended for the general population. 
• Human papillomavirus (HPV) (genital warts): This vaccine protects against HPV types that are responsible for most cervical cancers and genital warts. It is most effective when administered before the onset of sexual activity. For the general population, the HPV vaccine is recommended for all persons up through age 26. If you are an adult between ages 27 and 45, you should make the decision about getting the vaccine with your health care provider. If you have kidney disease or kidney failure and have an indication for needing this vaccine, it is appropriate for you follow the guidelines for the general population.     
• Varicella-zoster virus (shingles) vaccine: If you are 50 years old or older and living with kidney failure, you should receive the recombinant (non-live) zoster vaccine (RZV). If you are between the ages of 19 and 50 and are receiving immunosuppressive therapy, talk to your health care provider about whether you need the RZV vaccine.
• Pneumonia or Pneumococcal Vaccine: Patients with chronic kidney disease should receive this vaccine to protect against pneumonia, meningitis and other blood infections that can cause death.  
• Hepatitis B (HBV) vaccine: Typically given to infants in a series of shots between birth and 18 months, this vaccine protects against hepatitis B virus, which causes a type of liver disease that can either make you sick for a few weeks or can become a lifetime chronic illness. 

Ask your health care provider if you are up to date on these vaccines. If you are not, make a plan to become fully vaccinated.  

Can I get more than one vaccine at a time?

It is possible to receive multiple vaccinations at the same time. For example, you can receive both your COVID-19 and flu shot at the same appointment, which means only needing to visit your provider once. Talk to your health care provider about scheduling multiple vaccines in the same appointment. They can give you guidance on best practices for vaccines and what to expect if you are getting multiple shots. 

Still have questions? Check out our new website page for more information about vaccines and kidney disease. 

AKF is grateful to Moderna for their support of our vaccine educational materials.

Disclaimer: The information provided here is not intended to replace professional medical advice, diagnosis or treatment. Please consult your primary care doctor and/or nephrologist about your specific health care needs, including which vaccines you should get.