Essential vaccines for people with CKD, dialysis and kidney transplantation
Kidney disease and dialysis can increase the risk of certain infections. Vaccination is an important part of preventive kidney care. The vaccines you need may depend on your age, kidney function, dialysis status and whether you have had a kidney transplant.
Why is vaccination important in kidney disease?
People with chronic kidney disease (CKD), those on dialysis and kidney transplant recipients are at increased risk of infections due to altered immunity. Vaccination helps protect against serious and potentially life-threatening infections. Vaccination should ideally be reviewed and completed before dialysis or kidney transplantation whenever possible.
Engerix-B / Shanvac-B / Enivac B (or any approved brand)
Why important: Hepatitis B infection is a serious risk for patients with advanced CKD, patients approaching dialysis and especially haemodialysis patients. Vaccination is a key part of pre-dialysis care.
Route: Injection into a muscle (upper arm for adults, thigh for infants)
Dose: 2 ml (40 mcg) IM each time
Schedule (confirm with your nephrologist):
Note: Vaccine response may be lower in advanced CKD. Completing the full series is important.
Anti-HBs Antibody Monitoring
After completing the vaccination series, your nephrologist may check Anti-HBs antibody levels. In dialysis patients, an Anti-HBs level of ≥10 mIU/mL is generally considered protective. Periodic antibody monitoring and booster/revaccination may be required when immunity declines, as advised by your treating nephrologist.
Vaccination should ideally be completed before dialysis or kidney transplantation whenever possible.
Seasonal flu vaccine (Influvac or any approved brand)
Why important: Kidney patients can be at increased risk of complications from influenza. Annual vaccination helps reduce this risk.
Dose: 0.5 ml IM — once every year
When: Take the seasonal influenza vaccine every year at the recommended time for your region. The ideal timing depends on the influenza season and current local recommendations.
Protects against serious pneumococcal infection
Why important: People with CKD, nephrotic syndrome and kidney failure have an increased risk of serious pneumococcal infection.
Important — Your vaccination history matters
The appropriate pneumococcal vaccine and interval depend on your age, CKD stage, dialysis status, immune status and previous pneumococcal vaccination. Currently available options include PCV20, PCV21, PCV15 and PPSV23.
If you have previously received PCV13, PPSV23, PCV15, PCV20 or another pneumococcal vaccine, your next dose may be different. Do not assume that you need another dose without reviewing your vaccination record with your nephrologist.
Ask your nephrologist to review your previous vaccination record before receiving any pneumococcal vaccine.
Recombinant zoster vaccine — 2 doses
Recommended for:
Schedule: Usually given as 2 doses. The interval may vary depending on the patient's immune status. Confirm timing with your nephrologist.
Note: Shingrix is a non-live recombinant vaccine. The live shingles vaccine (Zostavax) is generally not recommended for immunocompromised patients.
As per current national recommendations
Why important: People with advanced CKD, dialysis patients and transplant recipients may be at increased risk of severe COVID-19.
Keep COVID-19 vaccination up to date according to the current age- and risk-based recommendations in your region.
Kidney transplant patients: Should follow their transplant team's vaccination schedule, as timing may need to be coordinated with immunosuppressive therapy.
Routine adult vaccination
Kidney patients should also remain up to date with routine adult vaccinations, including Tdap/Td according to the applicable adult immunization schedule.
What it protects against: Tetanus (lockjaw), diphtheria and pertussis (whooping cough).
Your nephrologist can advise on the correct booster schedule for your situation.
Your nephrologist may recommend additional vaccines
Your nephrologist may recommend additional vaccines depending on your age, kidney disease, immune status, travel plans and whether you are preparing for kidney transplantation.
These may include:
This list is not exhaustive. Do not assume you need every vaccine listed — your doctor will guide you based on your individual situation.
Plan early — some vaccines need time before surgery
Transplant candidates should have their vaccination status reviewed early during the evaluation process because:
Your transplant team will guide you on the correct timing. Do not self-schedule vaccinations without transplant team approval.
Site
Deltoid muscle (upper arm, 2-3 finger widths below shoulder)
Needle
25-26 gauge, 1 inch (25mm) for adults
Angle
90 degrees perpendicular to skin
Important Tips:
Common medicines for mild-to-moderate side effects after vaccination
| Reaction (प्रतिक्रिया) | Medicine (दवाई) | How to Take (कैसे लें) | Dose (मात्रा) |
|---|---|---|---|
| Fever (बुखार) | Tab Dolo 650 / Crocin 500 mg | After food (खाने के बाद) | 1 tab SOS |
| Body pain / Headache (शरीर दर्द / सिरदर्द) | Tab Paracetamol 500 mg / Crocin | After food (खाने के बाद) | 1 tab SOS |
| Pain / Swelling at injection site (टीके की जगह दर्द / सूजन) | Tab Ibuprofen 400 mg / Combiflam | After food (खाने के बाद) | 1 tab SOS |
| Allergic rash / Itching (एलर्जी की खुजली) | Tab Cetirizine 10 mg / Levocetirizine | After food (खाने के बाद) | 1 tab SOS |
| Vomiting / Nausea (उल्टी / जी मिचलाना) | Tab Emset 4mg / Ondem | Before food (खाने से पहले) | 1 tab SOS |
SOS = जरूरत पड़ने पर (As needed). These medicines are for mild-to-moderate reactions only.
Seek immediate medical attention if you experience:
Call emergency services or go to the nearest hospital immediately. Do not wait.
Kidney patients: Always check with your nephrologist before taking any medicine, even over-the-counter drugs. Some pain medicines (e.g., NSAIDs like Ibuprofen) may not be suitable for advanced CKD or dialysis patients.
Use this table to track your vaccines
| Vaccine | Dose / Date | Next Due | Remarks |
|---|---|---|---|
| Hepatitis B | ___/___/______ | ___/___/______ | ______________ |
| Influenza | ___/___/______ | ___/___/______ | ______________ |
| Pneumococcal | ___/___/______ | ___/___/______ | ______________ |
| COVID-19 | ___/___/______ | ___/___/______ | ______________ |
| Shingrix (Shingles) | ___/___/______ | ___/___/______ | ______________ |
| Tdap / Td | ___/___/______ | ___/___/______ | ______________ |
| Other: ________ | ___/___/______ | ___/___/______ | ______________ |
Consult a nephrologist for personalised vaccination advice based on your kidney disease, dialysis status and transplant plans.
Medical Disclaimer: This page provides general educational information and does not replace individual medical advice. Vaccination recommendations may vary depending on age, CKD stage, dialysis status, transplant status, immune status, previous vaccination and local guidelines. Please consult your nephrologist or transplant team before receiving vaccines. Vaccination schedules presented here are general guides and may not be appropriate for every patient.
