Effect of a booster dose of influenza vaccine in patients with hemodialysis, peritoneal dialysis and renal transplant recipients: A systematic literature review and meta-analysis

Abstract

Booster influenza vaccination has been recommended for patients with chronic renal disease in order to enhance the immune response to the influenza vaccine; however, the efficacy of a booster influenza vaccination is a matter of controversy. Therefore, we made a meta-analysis to determine the efficacy in patients with hemodialysis (HD), peritoneal dialysis (PD) and renal transplant recipient (RT). The sero-protection rate was used as a serologic parameter to describe the immune response to the vaccine. Statistical analysis was performed to calculate the pooled rate difference (RD) and 95% confidence interval (CI). The pooled RD for the H1N1, H3N2 and B influenza vaccines was 0.02 (95% CI: -0.02-0.06), 0.05 (95% CI: -0.01-0.11), 0.04 (95% CI: -0.02-0.10), respectively. We concluded that a booster dose of the influenza vaccine did not effectively enhance immunogenicity. Therefore, a booster dose of vaccine is not recommended for patients with hemodialysis, peritoneal dialysis and renal transplant recipients.

Keywords: hemodialysis; immunogenicity; influenza vaccine; meta-analysis; peritoneal dialysis; renal transplant recipient.

Figures

Figure 1.

Flow chart of study selection.

Figure 2.

Forest plot of the efficacy of a booster (H1N1) influenza vaccine in patients with HD, PD and RT.

Figure 3.

Forest plot of the efficacy of a booster (H3N2) influenza vaccine in patients with HD, PD and RT.

Figure 4.

Forest plot of the efficacy of a booster (B-type) influenza vaccine in patients with HD, PD and RT.