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Clin J Am Soc Nephrol. 2011 Sep;6(9):2208-14. doi: 10.2215/CJN.02160311. Epub 2011 Aug 18.

Efficacy of influenza A H1N1/2009 vaccine in hemodialysis and kidney transplant patients.

Author information

1
Department of Nephrology, Parc de Salut Mar, Passeig Maritim 25-29, 08003 Barcelona, Spain. mcrespo@hospitaldelmar.cat

Abstract

BACKGROUND AND OBJECTIVES:

Data are needed to assess safety and efficacy of the 2009 pandemic influenza A H1N1 vaccine in renal patients.

DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS:

We prospectively evaluated seroconversion, predictors of response, and vaccine safety in renal patients. Hemagglutination inhibition tests to detect serum antibodies against a new influenza A-H1N1 virus were performed in 79 transplant patients, 48 hemodialysis patients, and 15 healthy workers before and 1 month after vaccination. Healthy controls and 88 of 127 renal patients were vaccinated. Seroconversion was defined as at least 2 dilutions increase in titer.

RESULTS:

We excluded 19 individuals seroprotected (≥1/40) against the novel H1N1 in the initial sample. Efficacy rate in the 96 vaccinated individuals was 43.7% (42 of 96 seroconverted versus four of 27 nonvaccinated patients, P = 0.007). For vaccinated subgroups, efficacy was 41.8% in transplant patients (P = 0.039 versus nonvaccinated), 33.3% in hemodialysis patients (P = 0.450), and 81.8% in controls. Healthy controls showed better response to vaccine than transplant (P = 0.021) and dialysis (P = 0.012) patients. For the transplant subgroup, longer time after transplantation (P = 0.028) was associated with seroconversion, but no influence was found for age, gender, renal function, or immunosuppression. In the hemodialysis subgroup, younger age was associated with response (55.7 ± 20.8 versus 71.6 ± 10.1 years, P = 0.042), but other specific variables, including Kt/V or time on dialysis, were not. No serious adverse events were reported, and kidney function was stable.

CONCLUSION:

The novel influenza A 2009 H1N1 vaccine was safe in renal patients, although administration of a single dose of adjuvanted vaccine induced a poor response in these patients.

PMID:
21852661
PMCID:
PMC3358996
DOI:
10.2215/CJN.02160311
[Indexed for MEDLINE]
Free PMC Article
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