Which vaccinations do I need?

Your primary care provider is the best person to ask about which vaccinations you should get.  Another good source is Center for Disease Control and Prevention website, https://www.cdc.gov/vaccines/, which provides schedules for adults and children alike. COVID-19 Vaccination information can also be found at this website. Different forms of vaccines may be needed in patients with kidney disease. Certain illnesses are more common in this population. People with a kidney transplant, or kidney patient who may be pregnant or those with a weak immune system may not receive certain vaccines and caution is advised.

Why do I need a vaccination?

To prevent becoming seriously ill when exposed to certain bacteria and viruses, vaccines are used to boost your immunity against these bugs.  Vaccines have been developed to protect you from many common diseases, like the flu, COVID, pneumonia, and hepatitis B, and less common ones like measles, diphtheria, and tetanus. If acquired, many of these bugs can cause serious disease and lead to seriously sick and even cause death. In addition, some of these illnesses are contagious and you can pass them along to people around you.  Vaccines not only protect you, but also help protect others you are in contact with. People with chronic illnesses including those on dialysis and those with kidney transplants, especially elderly, have a weakened immune system and have higher risk of becoming seriously ill from exposure to these diseases, and benefit from vaccines.

Are vaccines safe?

Like many medications, there is a lot of experience worldwide with the use of vaccinations. Use of vaccines haves prevented so many serious diseases in the world. Vaccines are among the safest treatments available to everyone.

Certain vaccines should not be given to pregnant women, people with a kidney transplant, or those who are immune suppressed. Those who are allergic to certain vaccines should not receive them.  

Vaccine may have some possible side effects like with any medication. Some people could feel minor discomfort or soreness or a mild rash where the shot was given. Others might get a slight temperature or fever. However, these minor side effects may be normal and should not cause concern.

The possible harm from infections is much greater than harms from a vaccine. Talk with a healthcare provider about any questions or concerns you may have about vaccines.

How do vaccines work?

Vaccines usually contain parts of a dead or weakened bacteria or virus that is given as an injection to people. This induces the immune system to form antibodies that can fight these bacteria or viruses if they infect your body.  You will be prepared when a real infection happens with these antibodies which last a long time in your body. Some vaccines need a booster shot to induce more antibody formation to protect you better. That is why sometimes more than one shot is needed for some vaccines.  In other situations, a blood test may be needed to make sure there are enough antibodies in the blood to protect you in case of an infection.

If I have a transplant, which vaccines should I avoid?

Kidney transplant patients use medications that may weaken the immune system. As a result, live attenuated vaccines that may have a weakened virus or bacteria may not be safe and actually cause harm.   However, inactive vaccines are considered safe for transplant patients.  The live attenuated vaccines that should be avoided include: Nasal Influenza Mist (Not the injection). The injected flu shot is an inactive vaccine and safe.  Shingles (Herpes Zoster Virus), Chickenpox (Varicella Virus) and Measles, Mumps, Rubella (MMR)

How often do I need a vaccination?

Depending on the vaccine, you may need only one shot to protect you for life. Other vaccines may require booster shots or a series of shots. Some vaccines are needed only if you travel to a place where you are likely to contract a disease that is common to that area. (See chart below for a list of vaccinations commonly recommended for adults with kidney disease.)

Where do I get my vaccinations?

Vaccines may be offered at your primary care doctor offices, many pharmacies, dialysis centers, workplaces, community health clinics, health departments or other community locations. If your primary care provider does not carry all the vaccines recommended for you, ask for a referral to a center that does.

Federally funded health centers can provide Blogs if you don't have health insurance or a regular source of health care - you pay what you can afford based on your income. Locate a health center near you. Your state health department is another resource to find out where to get vaccines in your community.

Are these shots covered by insurance?

If you have Medicare, you pay nothing for COVID vaccine. Medicare Part B will also pay for Influenza (flu) vaccines, Pneumococcal vaccines, and Hepatitis B vaccines for persons at increased risk of hepatitis like dialysis patients or patients with diabetes. In addition, it pays for vaccines directly related to the treatment of an injury or direct exposure to a disease or condition, such as tetanus or rabies.

Medicare Part D plans identify covered vaccines through formularies. Part D plan formularies must include all commercially available vaccines (except those covered by Part B). A new preventive vaccine may not specifically appear in the formulary, but the plan may still cover the vaccine. Contact your plan to find out about coverage. Medicare Part D or Medicare Advantage Plan Part C that offers Medicare prescription drug coverage may also have coverage for Zoster (shingles) vaccine, MMR vaccine, and Tdap vaccine.

All vaccines recommended by CDC Advisory Committee on Immunization Practices (ACIP) are covered by California Medi-Cal Program, including indications that may be considered off-label per FDA licensure. Most state Medicaid agencies cover at least some adult immunizations, but some may not offer any vaccines.

If you serve in the military or are a military dependent, you are eligible for TRICARE. Under TRICARE, vaccines are covered according to the CDC recommended schedule.

If you do not currently have health insurance, visit www.HealthCare.gov to learn more about affordable health coverage options.

All Health Insurance Marketplace plans, and most other private insurance plans must cover certain vaccines without charging a copayment or coinsurance when provided by an in-network provider.

Which vaccines are recommended for me?

You can get vaccine recommendations by going to CDC Adult Vaccine Assessment Tool. ACIP recommends use of COVID-19 vaccines within the scope of the Emergency Use Authorization or Biologics License Application for the particular vaccine.  Interim ACIP recommendations for the use of COVID-19 vaccines can be found on the ACIP Vaccine Recommendations and Guidelines page.

Vaccinations Recommended for Adults with Chronic Kidney Disease, On Dialysis, or a Kidney Transplant

Vaccines	After Kidney Transplant	Chronic Kidney Disease and Dialysis
COVID-19	Recommended, Usually 2 doses	Recommended, Usually 2 doses
Flu (influenza)	Recommended, 1 dose every year	Recommended, 1 dose every year
Pneumonia (pneumococcal)	Recommended, ask your healthcare provider about the timing and spacing	Recommended, ask your healthcare provider about the timing and spacing
Hepatitis A ((HAV)	Recommended, 2 doses	Recommended, 2 doses
Hepatitis B (HBV)	Recommended, 3 doses	Recommended, 3 doses
Herpes Zoster (shingles)	DO NOT USE	Recommended (age 60 and older), 1 dose only Persons on immunosuppressive therapy should not receive the shingles vaccine
Tetanus, Diphtheriaacellular Pertussis (whooping cough)	Recommended 1- time dose of Tdap, then Td booster every 10 years	Recommended 1-time dose of Tdap, then Td booster every 10 years

* Based on Centers for Disease Control and Prevention Recommendations