Influenza in immunosuppressed populations: a review of infection frequency, morbidity, mortality, and vaccine responses

Ken M. Kunisaki, Edward N. Janoff

Research output: Contribution to journalReview articlepeer-review

421 Scopus citations


Patients that are immunosuppressed might be at risk of serious influenza-associated complications. As a result, multiple guidelines recommend influenza vaccination for patients infected with HIV, who have received solid-organ transplants, who have received haemopoietic stem-cell transplants, and patients on haemodialysis. However, immunosuppression might also limit vaccine responses. To better inform policy, we reviewed the published work relevant to incidence, outcomes, and prevention of influenza infection in these patients, and in patients being treated chemotherapy and with systemic corticosteroids. Available data suggest that most immunosuppressed populations are indeed at higher risk of influenza-associated complications, have a general trend toward impaired humoral vaccine responses (although these data are mixed), and can be safely vaccinated-although longitudinal data are largely lacking. Randomised clinical trial data were limited to one study of HIV-infected patients with high vaccine efficacy. Better trial data would inform vaccination recommendations on the basis of efficacy and cost in these at-risk populations.

Original languageEnglish (US)
Pages (from-to)493-504
Number of pages12
JournalThe Lancet Infectious Diseases
Issue number8
StatePublished - Aug 2009

Bibliographical note

Funding Information:
We thank Anne Marie Weber-Main for critically reviewing and editing the manuscript and Kristin Nichol for helpful comments on the manuscript. This work was supported by NIH grants K12 RR023247 and T32 HL07741 (to KMK), and R21 AI077069 (to ENJ) and the Veterans Affairs Research Service.

Funding Information:
KMK has received research funding from GlaxoSmithKline. ENJ has received research funding from MedImmune Inc and VaxInnate Corporation.


Dive into the research topics of 'Influenza in immunosuppressed populations: a review of infection frequency, morbidity, mortality, and vaccine responses'. Together they form a unique fingerprint.

Cite this