September 04, 2019
1 min read

High-dose influenza vaccine not superior to standard dose in patients on dialysis

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Investigators found patients on dialysis who received a high-dose influenza vaccination showed no additional effectiveness in reducing all-cause mortality or influenza outcomes compared to those who had a standard-dose vaccination.

Anne M. Butler, PhD, and colleagues examined the comparative effectiveness of standard-dose influenza vaccine vs. high-dose influenza vaccine in patients on maintenance dialysis therapy.

“An accumulating body of literature demonstrates that the [high-dose influenza vaccine] HDV is more effective than [standard-dose influenza vaccine] SDV in preventing influenza-related medical encounters, hospitalizations and mortality in the general population of adults 65 years and older,” Butler, of the division of infectious diseases at Washington University School of Medicine’s John T. Milliken Department of Internal Medicine, and colleagues wrote. “However, some studies of healthy older adults have not demonstrated a benefit of HDV.”

The researchers analyzed data of 507,552 patients who received in-center maintenance hemodialysis between the 2010 to 2011 and 2014 to 2015 influenza seasons. The outcomes were all-cause mortality, influenza or pneumonia hospitalization and influenza-like illnesses during influenza season.

Of the 225,215 Medicare patients with influenza, 97.4% received the standard-dose vaccine compared with 2.6% who received the high-dose vaccine.

Butler and colleagues identified similar weighted risk for both groups for all-cause mortality (risk difference = -0.08%) and influenza and pneumonia hospitalization (risk difference = -0.15). There was also a similar weighted risk in influenza-like illness (risk difference = 0%)

The researchers wrote that additional studies are needed on high-dose vaccines and other influenza vaccine strategies.

Disclosures: Butler reports investigator-initiated support from Amgen. Please see the study for all other authors’ relevant financial disclosures.