Dialysis – Transplantation
Kidney International (2003) 63, 738–743; doi:10.1046/j.1523-1755.2003.00787.x
Influenza vaccine delivery and effectiveness in end-stage renal disease
David T Gilbertson, Mark Unruh, A Marshall Mcbean, Annamaria T Kausz, Jon J Snyder and Allan J Collins
United States Renal Data System Coordinating Center and Minneapolis Medical Research Foundation, Minneapolis, Minnesota; University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania; University of Minnesota, Minneapolis, Minnesota; New England Medical Center, Boston, Massachusetts, USA
Correspondence: David T. Gilbertson, Ph.D., United States Renal Data System, 914 South 8th Street, Suite D-206, Minneapolis, Minnesota 55404, USA. E-mail: dgilbertson@nephrology.org
Received 8 August 2002; Revised 6 September 2002; Accepted 8 October 2002.
Abstract
Influenza vaccine delivery and effectiveness in end-stage renal disease.
Background
Influenza vaccination rates in the general population have been associated with improved outcomes, yet high-risk populations, such as end-stage renal disease (ESRD) patients, have received little attention in determining the potential benefits. This report assessed the frequency and effectiveness of influenza vaccination, while also assessing disparities in vaccination rates in the ESRD population.
Methods
Using the United States Renal Data System research files containing claims for all Medicare ESRD patients, vaccination rates and outcomes among vaccinated and unvaccinated persons for the 1997 to 1998 and 1998 to 1999 influenza seasons were compared after adjustment for baseline demographic factors and health characteristics.
Results
Vaccination rates in the ESRD population were less than 50% for each season. Influenza vaccination rates were lower in non-whites, women, younger patients, and peritoneal dialysis patients. Influenza vaccination was associated with a lower risk for hospitalization and death.
Conclusions
Despite universal coverage of free influenza vaccination, the ESRD population had a less than 50% vaccination rate for the years 1997 to 1998 and 1998 to 1999 as demonstrated by Medicare billing data. Substantial differences were found in vaccination rates among non-whites and peritoneal dialysis patients. This study confirms that the ESRD populations benefit from influenza vaccination, suggesting that dialysis providers should take advantage of all opportunities to immunize this high-risk group.
Keywords:
influenza, vaccination, mortality and vaccination, hospitalizations, immunization, peritoneal dialysis, hemodialysis
