BACKGROUND/AIM: Children on dialysis are under increased risk of influenza and invasive pneumococcal disease. Although vaccination against these microorganisms are recommended in dialysis patients and despite the fact that these vaccines can reduce disease burden and rates of hospitalization due to infection, vaccination rates are below expected and desired. We aimed to evaluate influenza and pneumococcal vaccination and infection rates in European pediatric dialysis centers. MATERIALS AND METHODS: In 16 centers from 11 countries, 357 pediatric dialysis patients were evaluated retrospectively during 1 year of observation period between 01.01.2014 and 01.01.2015. RESULTS: In all centers, vaccination policy included immunization of dialysis patients with inactive influenza vaccine and pneumococcal conjugate vaccine (PCV). Fifty percent of the centers recommended pneumococcal polysaccharide vaccine following routine PCV series. A significantly higher pneumococcal vaccination rate (43.9%) was seen in peritoneal dialysis (PD) patients compared to those on hemodialysis (HD) (32.9%) (p = 0.035), while the rates for influenza were similar (42.4% and 46.1% respectively, p = 0.496). Among all dialysis patients, 2.2% (n = 8) developed pneumonia and 6.4% (n = 23) was infected by Influenza. Pneumococcic pneumonia rate was 5% for 140 patients who received antipneumococcal vaccine, while only one pneumonia episode was recorded out of 217 unvaccinated patients (p = 0.007). The influenza virus infection rates were similar for patients vaccinated and nonvaccinated (7 % and 6 %, respectively). CONCLUSIONS: Although influenza and pneumococcal vaccines are highly recommended in pediatric dialysis patients, vaccination rates were lower than expected. Pneumococcal vaccination rates were higher in PD compared to the patients on HD. The rate of children with influenza infection was higher than pneumonia. The efficacy of influenza and pneumococcal vaccines was highlighted by the low infection rates. Higher pneumonia rates in patients vaccinated against pneumococcus compared to unvaccinated ones might be due to coexisting risk factors.

1st Pediatric Department Faculty of Medicine Aristotle University of Thessaloniki Thessaloníki Greece

Department of Pediatric Nephrology A and P Kyriakou Children’s Hospital Athens Greece

Department of Pediatric Nephrology Cerrahpaşa Medical School İstanbul Turkey

Department of Pediatric Nephrology Faculty of Medicine Ankara University Ankara Turkey

Department of Pediatric Nephrology Faculty of Medicine Çukurova University Adana Turkey

Department of Pediatric Nephrology Faculty of Medicine Gazi University Ankara Turkey

Department of Pediatric Nephrology Faculty of Medicine Padova University Padova Italy

Department of Pediatric Nephrology Faculty of Medicine University Hospital Motol Prague Czech Republic

Department of Pediatric Nephrology Faculty of Medicine University of Helsinki Helsinki Finland

Department of Pediatric Nephrology Great Ormond Street Hospital for Children London UK

Department of Pediatric Nephrology Hopital de Hautepierre Strasbourg France

Department of Pediatric Nephrology KfH Children’s Kidney Center Marburg Germany

Department of Pediatric Nephrology Medical University of Vienna Vienna Austria

Department of Pediatric Nephrology Mitera Children’s Hospital Athens Greece

Department of Pediatric Nephrology University Hospital Vall d’ Hebron Barcelona Spain

Department of Pediatric Nephrology Utoped Universitair Ziekenhuis Gent Ghent Belgium

Department of Pediatrics Nephrology and Hypertension Medical University of Gdansk Gdansk Poland

Department of Social Pediatrics Faculty of Medicine Hacettepe University Ankara Turkey

Dialysis Unit Department of Pediatrics IRCCS Istituto Giannina Gaslini Genoa Italy

Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico Milan Italy

Pediatric Center Institute of Clinical Medicine Vilnius University Vilnius Lithuania

Pediatric Nephrology Center for Pediatric and Adolescent Medicine Heidelberg Germany

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