Shingles Vaccine Essential For Protecting Kidney Disease Patients

People living with chronic kidney disease (CKD) face a significantly higher risk of developing shingles compared to the general population, and the consequences extend beyond just painful skin rashes. According to Hwang Won-min, a nephrology professor at Konyang University Hospital, patients with kidney disease should never underestimate the threat shingles poses. On the Korean Society of Nephrology’s (KSN) YouTube channel, he emphasized that shingles can worsen kidney function, making prevention critical for this vulnerable group.

CKD patients, as well as those undergoing dialysis or who have received kidney transplants, are especially susceptible to shingles. Hwang explained that CKD patients are approximately 1.4 times more likely to develop shingles, a figure similar for those on hemodialysis. The risk increases further for peritoneal dialysis patients, who have about a 3.6 times higher chance of contracting shingles. Kidney transplant recipients are the most at risk, with over eight times greater likelihood than the general population.

The increased vulnerability to shingles in people with kidney problems stems from a weakened immune system. Hwang described how, in CKD patients, white blood cells responsible for fighting infections are significantly less effective. As kidney function declines, toxins accumulate in the blood, impairing these critical immune cells. This diminished immune response makes kidney patients not only more prone to shingles infection but also more likely to experience worsening kidney disease, particularly if they have coexisting conditions like diabetes or hypertension.

Moreover, shingles can impact more than just the kidneys. Hwang pointed out that individuals with shingles face a heightened risk of cardiovascular issues, such as vascular disease, stroke, and acute coronary artery disease. In CKD patients, whose blood vessels are already weakened, this risk increases by 1.4 to 2 times. Shingles triggers inflammatory reactions in blood vessels, compounding health risks in people with compromised immunity. For these reasons, preventing shingles is critical for overall health in kidney patients.

Reflecting these concerns, the U.S. National Kidney Foundation recommends the shingles vaccine for those with kidney disease. The guidelines call for two doses of the vaccine, spaced two to six months apart, for CKD or dialysis patients aged 50 and older. For younger patients under 50 who are immunocompromised or on immunosuppressive therapy, vaccination may be advised after consulting a healthcare provider. Similarly, the U.S. Advisory Committee on Immunization Practices endorses two doses for kidney transplant recipients aged 19 and above.

Building on this, the KSN’s December 2024 infection control guidelines for artificial kidney units recommend vaccination with the recombinant shingles vaccine for dialysis patients aged 50 and over. Hwang explained that in the past, kidney transplant patients could not receive the live shingles vaccine due to safety concerns. However, advances in vaccine technology have led to a quadrivalent recombinant vaccine, developed through genetic recombination, which can safely protect these high-risk patients.

In Korea, the only licensed quadrivalent shingles vaccine suitable for CKD patients is GSK’s recombinant vaccine, Shingrix. Hwang highlighted that this newer vaccine requires two doses and offers more effective and longer-lasting protection than previous live vaccines. Importantly, it is safe for kidney transplant patients, marking a significant advancement in shingles prevention for this vulnerable population.

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