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High-Dose Influenza Vaccine Use in ESRD Patients
Vaccine; ePub 2018 Sep 6; McGrath, et al
Among US patients receiving hemodialysis, the use of high-dose influenza vaccine among patients with end-stage renal disease (ESRD) was very low, despite an overall influenza vaccination rate increase. Using data from the United States Renal Data System (2010-2013) researchers conducted a cohort study of 421,482 adult patients on hemodialysis and examined temporal trends in uptake of high-dose or standard trivalent influenza vaccine each influenza season. They used multivariate logistic regression to assess the association between individual-level variables and facility-level variables with vaccine receipt. They found:
- The proportion of patients with ESRD who were vaccinated with any influenza vaccine increased from 68.3% in 2010 to 72.4% in 2013.
- High-dose vaccines were administered to 0.9% of patients during the study period.
- Older patients and those at hospital-based vs free-standing dialysis facilities were more likely to receive high-dose vaccine.
- Blacks and patients with longer duration of ESRD were less likely to receive the high-dose vaccine.
McGrath LJ, Layton JB, Krueger WS, Kshirsagar AV, Butler AM. High-dose influenza vaccine use among patients receiving hemodialysis in the United States, 2010-2013. [Published online ahead of print September 6, 2018]. Vaccine. doi:10.1016/j.vaccine.2018.08.079.
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Vaccination for Prevention of Herpes Zoster, Ann Intern Med; ePub 2019 Feb 19; Prosser, et al
ACIP Updates Adult Immunization Schedule, Ann Intern Med; 2019 Feb 5; Kim, Hunter, et al
Influenza Vaccination Safety During Hospitalization, Mayo Clin Proc; ePub 2019 Jan 8; Tartof, et al
Acellular Pertussis Vaccine Is Safe & Effective, JAMA Pediatr; 2018 Nov; Wood, Nolan, et al
Influenza and Pertussis Vaccination in Pregnancy, Vaccine; ePub 2018 Nov 3; Wilcox, Bottrell, et al
The high dose flu vaccine has four times as much antigen as standard vaccine. The high dose influenza vaccine was found in a 2014 NEJM article to be over 21.6% more effective than the standard influenza vaccine. By 2017, about two-thirds of the influenza vaccine given to seniors was high dose. Even though patients on hemodialysis are high risk for influenza at all ages, only seniors should receive this vaccine. Although seniors have the highest influenza immunization rate of any group in the US, they only have about 70% uptake. Dialysis centers should make sure their patients get the influenza vaccine each year. — John Russell, MD