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Immunizations - Which Shots You May Need and Why

Immunizations may prevent people from contracting other diseases, infections and viruses. The immune system of a person with chronic kidney disease (CKD) becomes weakened, making it difficult to fight off many diseases and infections. Patients with CKD may become more susceptible to illness and even death if they do not receive regular immunization treatment. Getting the proper immunizations is an essential part of a person’s kidney care.

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 three immunization shots (also called vaccinations) many people with kidney disease receive are influenza, pneumococcal and hepatitis B.

Influenza – The influenza vaccine, also known as “the flu shot,” helps deter flu-like complications from entering the body.  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 23, this vaccine protects against 23 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. Blood tests are done to determine if someone has been exposed to hepatitis B.  

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) and tetanus. Please note that post-kidney transplant recipients or patients on immunosuppressant drugs for their kidney disease (such as lupus, glomerulonephritis, etc) should not receive certain live-vaccines. Speak with your doctor about which vaccines are right for you.

How do immunizations work?

Immunizations are given by a doctor or nurse. It is done by injecting a shot usually into your upper arm or leg. Immunization shots contain either a weakened or killed version of a particular bacteria or virus. Once it is injected, your immune system recognizes these particles and learns 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 normal and should not cause alarm. Talk with your healthcare 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 necessary 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 doses

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

What happens when you miss your scheduled immunization?

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. 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.  


Receiving immunization shots is important for chronic kidney disease and dialysis patients to help prevent contracting an infection, virus or other disease. Immunizations help round out your entire kidney care regimen, which includes taking your prescribed medicines, receiving dialysis treatments (if your kidney function is below 15%) and eating a kidney-friendly diet. Talk with your health care team about which immunizations you need and when you should receive the vaccinations so you can remain as healthy as possible.