Table 1.
Recommended Vaccines for Adults with CKD
| Vaccine | Dose and Schedule |
|---|---|
| Hepatitis B-recombinant | CKD Stages 3–4: Recombivax 10 ug: 3 doses (0, 1, and 6 months) Engerix-B 20 ug: 4 doses (0, 1, 2, and 6 months) Heplisav-B: 2 doses (0 and 1 months) CKD Stage 5: Recombivax 40 ug: 3 doses (0, 1, and 6 months) Engerix-B 40 mg: 4 doses (0, 1, 2, and 6 months) Heplisav-B: 2 doses (0 and 1 months) Booster dose when anti-HBs titer <10 mU/mL |
| Pneumococcal vaccine |
CKD patient naïve to Pneumococcal immunization: - Administer PCV13, - Wait at least 8 weeks after PCV 13 dose then administer PPSV23 (dose1) - Wait at least 5 years after the first dose of PPSV23 then administer PPSV23 (dose 2) *CKD patient previously immunized with PPSV23: - Administer PCV13 at least one year after PPSV23 (dose1) - Wait at least 8 weeks after PCV13dose and at least 5 years after PPSV23 (dose1), then administer PPSV23 (dose 2) *CKD patient previously immunized with PCV13: -Administer PPSV23 (dose1) at least 8 weeks after PCV 13 dose - Wait at least 5 years after PPSV23 dose1, then administer PPSV23 (dose2) |
| Influenza inactivated | One dose annually before onset of influenza season |
| Hepatitis A inactivated | Two-dose series of single antigen hepatitis A vaccine (Havrix at 0 and 6–12 months or Vaqta at 0 and 6–18 months; minimum interval, 6 months) - Administer based on risk |
| Tetanus-diphtheria (Td) and tetanus -diphtheria-acellular pertussis (TdaP) | Primary: three doses (0,1, and 6–12 months) including one (TdaP) Booster dose with (Td) every 10 years |
| MMR | Administer if no evidence of immunity: 2 doses of MMR at least 28 days apart |
| VAR | Two doses of VAR vaccine 4–8 weeks apart if not previously received. If previously received one dose, administer 1 dose of VAR at least 4 weeks after the first dose |
| RZV | Two doses of RZV 2–6 months apart to adults > 50 years regardless of past episode of herpes zoster or ZVL |
Abbreviations: PCV13, 13-valent pneumococcal conjugate vaccine; PPSV23, 23-valent pneumococcal polysaccharide vaccine; anti-HB, antibody to hepatitis B surface antigen; MMR, measles, mumps, and rubella; RZV, recombinant zoster vaccine; VAR, varicella.