JJ KAPOJOS1, A BRITTON1, T WHITTINGTON1, SP McDONALD1
1Central Northern Adelaide Renal and Transplantation Service, Royal Adelaide Hospital, Adelaide, South Australia
Aim: To analyse the effectiveness of an “active” influenza vaccination policy in hemodialysis (HD) patients in a large metropolitan dialysis service.
Background: In response to a high frequency of hospitalisations, in 2016 a program of actively offering vaccination to satellite HD patients was undertaken. Influenza B increased in 2015; influenza vaccination was changed to quadrivalent in 2016.
Methods: Numbers of patients admitted with a positive influenza nucleic acid testing (NAT) were tabulated from 2012 to 2016. Positive cases in HD patients were further characterised for hospital length of stay, age, gender, race, potential contributors and mortality.
Results: Included were 550 patients managed across 15 units. Vaccination uptake improved from 67.3% in 2015 to 77.8% in 2016. However, the proportion of all hospital influenza admissions coded to the renal unit did not change from the 2012-15 period to 2016. Of the 669 positive influenza NAT results among hospital admissions in 2015, 16 cases were HD patients (2.4%) versus 16 HD patients of 520 positive influenza NAT results (3%) in 2016. Median length of stay was 3 days in 2015 and 2.5 days in 2016. Median age and proportion of Indigenous Australians were similar in both years. None of the cases in 2016 were influenza B, whereas 50% cases in 2015 were influenza B. There were no deaths during hospitalisation in both years.
Conclusions: Early results show the initiative to provide influenza vaccination in HD facilities improved the proportion who were vaccinated, but has only marginally improved the hospital length of stay and has not improved the number of laboratory diagnoses of influenza in dialysis population. The incidence of influenza B has declined with quadrivalent vaccination.