2015 Volume 3 Issue 2 Pages 139-146
Effect of vaccination on kidney transplant recipients is suboptimal due to diminished immune response post transplant. Therefore, it is reasonable to complete a series of vaccinations to achieve seroprotection pre transplant, ideally in early stage of CKD. While live vaccines are generally contraindicated pot transplant, inactivated vaccines are safe, and vaccine dose, frequency and injection site have been studied to improve outcomes. Although, subcutaneous vaccination is least likely to achieve seroprotection compared to intramuscular and intradermal vaccination, most preferred injection site of inactivated vaccines in Japan is subcutaneous. Thus, we should consider intramuscular vaccination in hepatitis B and pneumococcal vaccine (PCV13 and PPSV23). According to the Advisory Committee on Immunization Practices (ACIP) in the U.S., “immunocompromised persons”, to whom we reasonably could apply “kidney transplant recipients”, should receive a dose of PCV13 first, followed by a dose of PPSV23 at least 8 weeks later.
