No need to increase dose of influenza vaccine for haemodialysis patients
The high-dose influenza vaccine (HDV) confers no additional protection beyond the standard-dose vaccine (SDV) in terms of all-cause mortality or influenza-related outcomes in adults undergoing maintenance haemodialysis, as shown in a recent study.
Researchers accessed the US Renal Data System and identified 507,552 adult patients who were undergoing in-centre maintenance haemodialysis between the 2010–2011 and 2014–2015 influenza seasons. Of the patients, 97.4 percent received SDV and 2.6 percent received HDV within 225,215 influenza patient-seasons.
Outcomes during the influenza season did not significantly differ between the HDV and SDV groups. The risk difference, obtained by propensity score weighting of Kaplan-Meier functions, was −0.08 percent (95 percent CI, −0.85 to 0.80) for all-cause mortality, 0.15 percent (−0.69 to 0.93) for hospitalization due to influenza or pneumonia, and 0.00 percent (−1.50 to 1.08) for influenza-like illness.
Results were similar in subgroups defined by age group, influenza season, dialysis vintage, month of influenza vaccination and vaccine valence.
In light of the present data, the researchers stressed that the additional cost and side effects associated with HDV should be considered when offering the vaccine.
The present study was limited by residual confounding and outcome misclassification. Additional research is needed to investigate HDV and other influenza vaccine strategies.