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Immunizations—Which Shots You May Need and Why

Immunizations may prevent people from contracting viral diseases. The immune system of a person with chronic kidney disease (CKD) can become weakened, making it difficult to fight off diseases and infections. Patients with CKD may become more susceptible to illness if they do not receive regular immunizations. Getting proper immunizations is an essential part of preventative care for someone with CKD.

What type of immunization do you need?

Whether you are on dialysis, what kind of comorbidities you may have, your age and where you live can determine which type of immunization you may need. The four immunization shots (also called vaccinations) many people with kidney disease receive are influenza, pneumococcal, hepatitis B and COVID-19.

Influenza – The influenza vaccine is also known as “the flu shot.” The flu shot helps prevent people from getting the flu or minimizes complications if they do get the flu.  Symptoms of the flu include headaches, body aches, high fever, sore throat, fatigue and a runny nose, among other things. The flu virus may be contracted from everyday, person-to-person contact in which germs can spread.

Pneumococcal – Called the Pneumovax 20, this vaccine protects against 20 different types of infectious bacteria pneumonia. Typically, symptoms of pneumonia begin slowly. They include high fever, chills, coughing, headaches, trouble breathing, chest pains and muscle aches, among other symptoms. During an exam, the doctor can identify pneumonia when hearing a patient’s wheezing or broken up breathing pattern, and may order a chest x-ray and blood work.

Hepatitis B – The hepatitis B vaccine can inhibit a person from becoming infected with the virus. Hepatitis B can develop if a person is exposed to contaminated blood or if the patient exchanges fluids with a person who has the virus. Hepatitis B is a blood-borne organism—not airborne—so you will not contract it through regular contact, such as hugging another person, someone sneezing or coughing in the same room, shaking hands or eating and drinking. Some people may not have symptoms, but if they do, the symptoms are similar to the flu. At dialysis, regular blood tests are done to determine if someone has been exposed to hepatitis B.  

COVID-19 – The COVID-19 vaccines help our bodies develop immunity to the virus that causes COVID-19. Similar to a flu shot, the vaccines help prevent you from getting sick with COVID-19. DaVita provides the Pfizer vaccine for patients and teammates. In the community, the two main vaccine types available are Pfizer and Moderna. To learn more about the COVID-19 vaccine, visit our COVID-19 Information page.

Other immunizations

Other preventative immunization shots chronic kidney disease and dialysis patients should consider are measles, mumps and rubella (MMR), meningitis, chickenpox (if you have never been exposed), tetanus, polio and shingles. Speak with your doctor about which vaccines are right for you.

How do immunizations work?

Immunizations are administered by a doctor or nurse. Typically vaccinations are administered by injecting a shot, usually into your upper arm or leg. Once it is injected, your immune system recognizes these particles as foreign and creates antibodies to attack them in order to prevent the disease from occurring. Some patients may experience discomfort, such as soreness or rash at the injection site. Others may get a slight fever, but such symptoms are a good sign and indicate your immune system is doing its job. Talk with your care team about any concerns you have after you are vaccinated.

Schedule for immunizations

There are specified times when a chronic kidney disease patient needs to be immunized. Certain vaccinations may have been received when you were a child or you may only need to get a particular vaccine once in your life. Here is a table describing which vaccinations are important for chronic kidney disease and dialysis patients.

Type of immunization

Dosage for chronic kidney disease and dialysis patients


1 dose once per year


1 or 2 doses

Hepatitis B

3 or 4 doses


2 shots primary series; boosters as recommended

Measles, mumps and rubella (MMR)

1 or 2 doses


1 or more doses (dependent on patient)

Varicella (chickenpox vaccine)

2 doses


1 dose every 10 years


1 dose


1 dose

What happens when you miss your scheduled immunization?

Missing vaccinations may lead to illness. Since a chronic kidney disease and dialysis patients’ immune systems are not as strong as a person in the general population, there is a greater risk of contracting a disease. Although washing your hands and staying away from sick people may help prevent contracting a virus or bacterial infection, these tactics will not always work. 


Receiving immunization shots is important for chronic kidney disease and dialysis patients to help prevent viral infections. Immunizations help round out your entire kidney care regimen, which includes eating a kidney-friendly diet, taking your prescribed medicines and receiving dialysis treatments if prescribed. Talk with your care team about which immunizations you need and when you should receive the vaccinations so you can remain as healthy as possible.