Last Updated: October 29, 2024
Medically reviewed by NKF Patient Education Team
About vaccines
Vaccines can help keep adults and children from getting or becoming seriously ill with a disease. They protect against many diseases, like the flu, diphtheria, tetanus, hepatitis B, COVID-19, and pneumonia. People who get some of these diseases can pass them to others, so vaccines can also help protect other people.
Some people have a higher risk of becoming seriously ill from these diseases, especially older adults, children, and people with chronic illnesses. Vaccines are important to help prevent serious diseases in children with CKD, those on dialysis, and immunocompromised people, such as kidney transplant recipients.
How vaccines work
Vaccines work by imitating an infection, helping the immune system learn how to fight off the actual germ if your child is exposed in the future.
After vaccination, your child’s body may produce minor symptoms, such as a mild fever or soreness at the injection site. These symptoms are normal and show that the body is building protection. Full immunity typically takes a few weeks to develop, so a child can get sick if exposed to a germ right before or shortly after receiving the vaccine.
While vaccines greatly reduce the chance of getting seriously ill, it is still possible to contract the disease even after vaccination. However, vaccinated individuals are much less likely to develop severe illness.
Some vaccines require more than one dose to provide full protection. Here are the different types:
- Multi-dose vaccines: Some vaccines require 2 or more doses to build complete immunity. For example, the hepatitis B vaccine requires several doses spread out over time.
- Boosters: Over time, the protection from certain vaccines may wear off, requiring a booster dose to maintain immunity. For instance, children should receive a tetanus booster (Tdap) around age 11.
- Yearly: Some vaccines, like the flu shot, are needed every year. This is because the virus changes and the vaccine must be updated to protect against the most common strains each year.
Types
Different types of vaccines protect against different diseases. Here are the main types:
- Inactivated (non-live) vaccines: Contain germs that have been killed but still teach the immune system how to fight the real germ. Examples include the flu shot and polio vaccine.
- Live, attenuated vaccines: Contain weakened versions of germs. These vaccines can be effective in healthy children but are not recommended for children with a kidney transplant or immunocompromised.
- Toxoid vaccines: These prevent diseases caused by bacteria that produce toxins (poisons) in the body. In making these vaccines, the toxins are weakened so they cannot cause illness.
- Weakened toxins are called toxoids. When the immune system receives a toxoid vaccine, it learns how to fight off the natural toxin.
- An example of a toxoid vaccine is the tetanus vaccine, which contains tetanus toxoids.
- Subunit vaccines: Use only parts of the germ to stimulate the immune system. The hepatitis B vaccine is an example.
- mRNA vaccines: Teach the body to produce a small piece of the germ, which triggers an immune response. This type of vaccine has been used to protect against COVID-19.
People who are immunocompromised -- for example, children who have received kidney transplants -- should not get live vaccines. If your child has received a kidney transplant, be sure to tell their healthcare provider before having them vaccinated.
Effectiveness
Vaccines are a very effective way to keep children healthy and help your child’s body prepare to fight these germs if they become infected. This means that even if your child gets vaccinated, it is still possible to get the disease, but they are much less likely to become seriously ill. Vaccination aims to give your child’s body a better chance to fight off infections quickly.
It takes time for the immune system to build protection after getting vaccinated. Most of the immune response develops within a few weeks for vaccines that only require one dose. Vaccines that require multiple doses provide some protection after the first dose, but full immunity occurs only after completing the full vaccine series. Your child needs to get all the doses on the recommended schedule to get the best protection.
The effectiveness of vaccines can vary depending on your child’s immune system. Children with weakened immune systems, such as those with CKD, on dialysis, or who have had a kidney transplant, are at a higher risk for developing serious illness. Their immune systems may not respond as strongly to vaccines, so children with weakened immune systems may need higher doses or extra doses of certain vaccines to get enough protection.
Children can have a weakened immune system for various reasons, such as long-term dialysis, certain medications (like anti-rejection drugs after a kidney transplant), or chemotherapy. Not all children with weakened immune systems are affected in the same way. Some may have a very high level of immunosuppression, while others may only have a slightly weakened immune system. Your child’s doctor can recommend the doses or types of vaccines that are best for their situation.
Side effects
As with any medication, vaccines may also have side effects. Most children may feel minor discomfort after getting vaccinated, such as:
- Soreness or a mild rash on the skin where the vaccine was given
- Low fever
- Headache
- Feeling tired
These mild side effects are normal and should not cause concern. They are a sign that your child’s body is building protection against the disease. Typically, these symptoms go away within a few days.
Serious Side Effects
More serious side effects are very rare but can happen. Serious reactions to vaccines may include:
- Allergic reactions, such as hives, swelling of the face and throat, fast heartbeat, dizziness, or weakness
- Seizures
- A rare immune system reaction called Guillain-Barré Syndrome, which may cause tingling and weakness in the feet, legs, arms, or face, as well as shortness of breath or difficulty swallowing
If your child experiences any of these serious symptoms, call 911 or go to the hospital immediately. It’s important to note that a serious reaction to one vaccine does not necessarily mean your child will have a serious reaction to other vaccines. Still, discussing any concerns with your healthcare provider is always best.
Vaccine Safety
Vaccines are the safest way to protect children from serious diseases and prevent illness. Natural infections are much more likely to cause severe complications than vaccine side effects. This is true even for diseases that some may consider mild, like chickenpox. It’s impossible to predict who might get seriously ill from an infection, so vaccination is important to protect your child and others
If you are worried about potential side effects, the National Vaccine Injury Compensation Program (VICP) was created to help people who may have suffered from certain vaccines. More information about this program is available on their website at https://www.hrsa.gov/vaccine-compensation.
Additional considerations
Special considerations for children with a kidney transplant
Children who have received a kidney transplant are immunocompromised due to their need to take anti-rejection medications, which makes live vaccines unsafe for them. Vaccines such as the nasal flu, MMR, and varicella vaccines should be avoided. Always consult your child’s doctor before vaccine administration in immunocompromised children.
Cost of vaccines
The cost of vaccines varies. Commercial medical insurance usually covers them.
The Vaccines for Children (VFC) Program provides free vaccines to children eligible for Medicaid, uninsured, underinsured, or American Indian/Alaska Native. This program helps ensure that all children, including those with chronic kidney disease or who have had a transplant, receive the vaccines they need at no cost.
Medicaid covers routine childhood vaccinations at no cost to eligible children. These vaccines include flu shots, pneumonia, and all other recommended vaccines. You can check with your child’s healthcare provider or Medicaid to confirm which vaccines are covered and how to access them through your local provider.
Some states may require a prescription from your child’s healthcare provider before you can receive a vaccine at a pharmacy or get coverage through Medicaid. Check with your state’s Medicaid office or your child’s healthcare provider for specific requirements.
