Influenza vaccine delivery and effectiveness in end-stage renal disease

David T. Gilbertson, Mark Unruh, A. Marshall McBean, Annamaria T. Kausz, Jon J. Snyder, Allan J. Collins

Research output: Contribution to journalArticlepeer-review

107 Scopus citations


Background. Influenza vaccination rates in the general population have been associated with improved outcomes, yet high-risk populations, such as end-stage renal disease (ESRD) patients, have received little attention in determining the potential benefits. This report assessed the frequency and effectiveness of influenza vaccination, while also assessing disparities in vaccination rates in the ESRD population. Methods. Using the United States Renal Data System research files containing claims for all Medicare ESRD patients, vaccination rates and outcomes among vaccinated and unvaccinated persons for the 1997 to 1998 and 1998 to 1999 influenza seasons were compared after adjustment for baseline demographic factors and health characteristics. Results. Vaccination rates in the ESRD population were less than 50% for each season. Influenza vaccination rates were lower in non-whites, women, younger patients, and peritoneal dialysis patients. Influenza vaccination was associated with a lower risk for hospitalization and death. Conclusions. Despite universal coverage of free influenza vaccination, the ESRD population had a less than 50% vaccination rate for the years 1997 to 1998 and 1998 to 1999 as demonstrated by Medicare billing data. Substantial differences were found in vaccination rates among non-whites and peritoneal dialysis patients. This study confirms that the ESRD populations benefit from influenza vaccination, suggesting that dialysis providers should take advantage of all opportunities to immunize this high-risk group.

Original languageEnglish (US)
Pages (from-to)738-743
Number of pages6
JournalKidney international
Issue number2
StatePublished - 2003

Bibliographical note

Funding Information:
This project was supported with Federal funds from the National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, under Contract No. N01-DK-9-2343. Dr. Unruh was supported by NIH/T32-DK07777 Training Grant in Epidemiology, Clinical Trials and Outcomes Research. We thank Ms. Beth Forrest for help in manuscript preparation and submission.


  • Hemodialysis
  • Hospitalizations
  • Immunization
  • Influenza
  • Mortality and vaccination
  • Peritoneal dialysis
  • Vaccination


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