As fall begins, so does the season for respiratory viruses. Certain adults, including those with chronic kidney disease (CKD) or end-stage kidney disease (ESKD), are at higher risk for developing serious complications from these viruses. To help avoid getting sick and prevent additional health issues, it is important for individuals living with CKD or ESKD to receive recommended vaccines.
Which vaccines are recommended for CKD/ESKD patients? This fall, influenza, COVID-19, and respiratory syncytial virus (RSV) vaccines should be top priorities. At the same time, it is important not to overlook other vaccines that provide year-round protection. These include pneumococcal, hepatitis B, and shingles immunizations. Patients should always consult their healthcare providers to understand which vaccines are right for them.
Fall 2025 Vaccine Priorities
Influenza
Risk: Patients with CKD and ESKD are more likely to experience pneumonia, hospitalization, and death related to influenza (also known as “the flu”).
Recommendation: All patients aged six months and older should receive an annual flu vaccine, ideally by early October. Vaccination at this time ensures protection throughout the peak of flu season, when efficacy is strongest.
COVID-19
Risk: COVID-19 infection not only raises the risk of severe illness and hospitalization but also increases the likelihood of acute kidney injury and can accelerate CKD progression.
Recommendation: Updated fall 2025 vaccines are now available for adults 65 years and older, as well as younger adults and children with underlying conditions such as CKD or ESKD. Clinicians should encourage patients to receive their vaccine before winter surges, when the virus is more likely to circulate widely.
Respiratory Syncytial Virus (RSV)
Risk: RSV is often mistaken for a common cold, but in high-risk adults it can progress to severe respiratory or cardiopulmonary complications.
Recommendation: Adults 75 years and older should receive the RSV vaccine. Adults aged 50 – 74 with CKD, ESKD, or other comorbidities such as diabetes or obesity may also benefit from vaccination. A single dose provides durable protection, making early fall the best time to receive it.
Year-Round Vaccine Protection
Pneumococcal Infections
Risk: Pneumococcal infections are a leading cause of pneumonia in adults and are associated with higher mortality and cardiovascular complications in patients with CKD and ESKD.
Recommendation: Patients with CKD or ESKD should begin pneumococcal vaccination at age 19. For adults without chronic conditions, vaccination is recommended beginning at age 65.
Hepatitis B Vaccine
Risk: Because dialysis involves frequent blood exposure, patients with ESKD face a heightened risk of contracting hepatitis B, which can lead to serious liver complications and affect transplant eligibility.
Recommendation: Patients should complete a three- or four-dose hepatitis B vaccine series over six months if they have not already been vaccinated. This is especially important for adults progressing toward ESKD.
Zoster (Shingles) Vaccine
Risk: CKD and ESKD increase the risk of shingles and its complications, such as postherpetic neuralgia and vision problems.
Recommendation: Adults aged 50 and older (regardless of kidney disease) should receive the two-dose shingles vaccine to reduce the risk of developing shingles and related complications.
Key Takeaway for Fall 2025
Fall represents the critical window for influenza, updated COVID-19, and RSV vaccines. These immunizations can prevent hospitalizations and emergency department visits, reduce complications, and save lives during the respiratory virus season. At the same time, patients and their providers should consider pneumococcal, hepatitis B, and shingles vaccines, which provide essential year-round protection.
Doing Our Part
Healthmap Solutions’ Care Navigation team supports patients by helping them learn about the different vaccines that may be right for them. They also assist with coordinating vaccine appointments with providers and conducting routine vaccine reviews for members in Healthmap’s Kidney Population Health Management program. By reinforcing timely immunization for both seasonal and year-round vaccines, Healthmap helps reduce preventable complications and improve patient outcomes.