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    Vaccinations Before and After Kidney Transplantation

    by Steven Katznelson, M.D., Medical Director, Kidney Transplant Program and Laura Miyashita

    Due to an increased risk of developing infections posttransplant, kidney transplant candidates and recipients are urged to stay up-to-date on their vaccinations. “Vaccinations and their timing are critical for kidney transplant patients,” says Steven Katznelson, M.D., medical director of California Pacific Medical Center’s Kidney Transplant Program. He explains “Having end stage renal disease or being on immunosuppressive medications after a successful kidney transplant may make vaccinations less effective, so timing is important.”

    Pre-Transplant Vaccinations

    Appropriate vaccinations should be given as early as possible before one’s transplant. “Some vaccinations—especially those requiring multiple administrations such as the hepatitis B vaccine—may take a long period of time to have an effect,” says Katznelson. “By administering this type of vaccine early, there is a greater likelihood one will be protected by the time the kidney transplant occurs.” In the case of hepatitis B vaccination, one’s local doctor will monitor response to the vaccination. If an individual doesn’t have an adequate response to the vaccine, extra injections may be necessary.

    Post-Transplant Vaccinations

    For the first 2-3 months after transplantation, a patient’s response to vaccinations may be diminished due to the high doses of anti-rejection medications used immediately after surgery. Accordingly, it may not be worthwhile to get vaccinations during this period. Thereafter, transplant recipients should receive certain vaccinations on a regular basis. “For example, patients should get the influenza vaccine each year early in flu season—by October or November,” says Katznelson. He adds, “Many patients are concerned about side effects of the flu vaccines; however, the risk of acquiring influenza or developing a serious complication far outweigh the vaccine’s risk of side effects. Similarly, the vaccine to strep pneumoniae (a common cause of bacterial pneumonia) should be given before transplant and every five years following.”

    Live Virus Vaccine Warning

    “Live virus vaccines such as the herpes zoster vaccine (for chicken pox or shingles) should never be given to kidney transplant recipients as the these vaccines can actually cause life-threatening infections,” warns Katznelson. He cautions that if one’s doctor feels that a live virus vaccine is absolutely necessary, it should be administered at least one month prior to transplant.

    Vaccinations Recommended Before and After Kidney Transplantation

    Vaccinations are a great way to stay healthy before and after a kidney transplant. Please consult your local health care team to make sure you are up-to-date on your vaccinations.

    Recommended Vaccinations
    Vaccine Before TransplantAfter TransplantFrequency After Transplant
    Influenzarecommended recommendedyearly in October or November
    Hepatitis Brecommendedif not vaccinated before transplantn/a
    Strep Pneumoniae recommendedrecommendedevery 5 years
    Tetanus recommendedrecommendedbooster every 5 years
    Diphtheriarecommended recommended booster every 10 years
    Chicken Pox/Shinglesrecommended
    (in most cases)
    not recommended n/a