Vaccination Strategies in Adult Dialysis Patients: A Global, Temperate‑Tropical Epidemiological Feature

Review Article

Abstract

Background: Patients receiving maintenance dialysis have elevated risks of vaccine‑preventable infections and reduced vaccine immunogenicity due to uremia‑associated immune dysfunction and repeated healthcare exposure. Geographic variation in infectious burden influences vaccination strategy implementation.

Objective: To comprehensively review immunization procedures in adult dialysis patients, integrating immunologic mechanisms, clinical effectiveness, global epidemiologic variation (temperate vs tropical differences), and implementation practices.

Methods: Narrative synthesis of systematic reviews, clinical studies, and expert recommendations pertaining to vaccine immunogenicity and clinical outcomes in chronic kidney disease and dialysis populations.

Results: Enhanced hepatitis B vaccine regimens improve seroprotection and survival. Combined influenza and pneumococcal vaccination are associated with reduced all‑cause mortality in dialysis patients. COVID‑19 vaccination elicits robust humoral responses with acceptable safety profiles, though effectiveness is lower than in healthy controls. Tropical regions face higher endemic burdens of hepatitis B and year‑round influenza, requiring context‑adapted protocols. Implementation science suggests dialysis‑unit–based vaccination programs improve uptake and outcomes.

Conclusion: Immunization in dialysis patients requires higher‑dose regimens, booster strategies, and context‑specific adaptation to regional epidemiologic patterns. Dialysis facilities should adopt structured vaccination frameworks to reduce infection‑related morbidity and mortality globally.