Influenza vaccination in the first year after renal transplantation is safe and is associated with a lower risk of subsequent allograft loss and death, a study found.
The study was unable to assess whether protective antibodies formed after vaccination, but researchers found that low vaccination rates because of concerns of precipitating allograft rejection appear to be unwarranted.
Frank Hurst, MD, of Walter Reed Army Medical Center in Washington, DC, and his colleagues assessed Medicare claims for influenza vaccination and influenza infections in 51,730 adult Medicare patients. All patients were transplanted for the first time from January 2000 to July 2006 and they were followed through October 2006.
A total of 9,678 patients (18.7%) were vaccinated against the flu in the first year after transplantation. These individuals were 23% less likely to experience organ loss and 18% less likely to die during the study period than those who were not vaccinated. A total of 310 patients (0.6%) patients got the flu, but they were no more likely to experience organ loss than patients who did not get the flu, the researchers reported in the Clinical Journal of the American Society Nephrology (2011;6:1192-1197).
Current guidelines recommend flu vaccination for all patients following transplantation, but limited data have been available to support the safety and efficacy of this practice in the early period after transplantation. Available evidence suggests some degree of serologic response to flu vaccination more than six months post-transplantation, presumably as a result of the reduction of overall levels of immunosuppression.
Dr. Hurst’s group wrote that “the ideal timing of vaccination with regards to effective immunoprophylaxis remains to be determined.”