Recommendations

What Are the National and Global Recommendations for Pneumococcal Vaccination in Chronic Renal Diseases?

The CDC’s ACIP (2019) recommends 1 dose of PCV13 in persons aged ≥50 years with CRF.¹ In patients with CRF aged between 50 and 64 years, 1 dose of PPSV23 is recommended ≥8 weeks after PCV13 and ≥5 years after any PPSV23 at the age of <65 years. In patients with CRF aged ≥65 years, 1 dose of PCV13 is recommended, if not received PCV13 previously. For PPSV23 in this age group, 1 dose is recommended ≥8 weeks after PCV13 and ≥5 years after any PPSV23 at <65 years.1 Other global guidelines which recommend the use of pneumococcal vaccines in patients with CKD are the Spanish Society of Nephrology (2014), the National Kidney Foundation (2015) and the High Council of Public Health of France (2017).^2-4 Various national guidelines, like the Indian Society of Nephrology (2016), IMA (2018) and IAOH (2020) recommend pneumococcal vaccination in chronic renal diseases.^5-7 The immunisation strategies should be formulated early in the course of progressive renal disease to maximise the likelihood of vaccine-induced immunity since the secondary antibody responses are less affected by immune compromise than primary antibody responses.^5-7

ACIP, Advisory Committee on Immunization Practices; CDC, Centers for Disease Control and Prevention; CRF, chronic renal failure; IMA, Indian Medical Association; IAOH, Indian Association of Occupational Health; PCV13, 13-valent pneumococcal conjugate vaccine; PPSV23, 23-valent pneumococcal plain polysaccharide vaccine.

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