Last updated: December 10, 2025
Medically reviewed by: NKF Patient Education Team
Vaccine information designed for children (under 19 years) living with kidney disease, on dialysis, or a kidney transplant.
NKF will continue to be a clear and trusted resource for information on the impact of vaccination policy for people living with kidney diseases. Years of evidence have shown vaccines to be safe and effective. They are crucial to the health and survival of patients with kidney disease, many of whom are immunosuppressed.
About vaccines
Vaccines help your child’s body fight off diseases like the flu, tetanus, hepatitis B, COVID-19, shingles, and pneumonia. Getting vaccinated can keep children from getting very sick if they do catch one of these illnesses.
Some diseases can spread from person to person. When more people get vaccinated, it helps protect everyone – especially those who are more likely to get very sick, such as children living with kidney disease.
Uses
Vaccines are very important for children with chronic kidney disease (CKD), those who are on dialysis, and children who have a weakened immune system (immunosuppressed), such as kidney transplant recipients. Vaccines can help prevent serious infections and keep your child healthier.
How vaccines work
Vaccines help protect from certain diseases by teaching your child’s body how to fight them. They do this by acting like a mild “practice” infection. This helps the immune system learn what to do if exposed to the real disease later.
It can take a few weeks after getting a vaccine for your child’s body to be fully protected. That’s why someone might still get sick right before or just after getting a vaccine – the body hasn’t had time to build up full immunity (protection) yet. Even if your child does get the disease, being vaccinated usually means they won’t get as sick.
Some vaccines need more than one dose to work best or keep working over time:
- Multi-dose vaccines: Some vaccines work better after 2 or more doses. For example, the hepatitis B vaccine requires several doses spread out over time.
- Boosters: Over time, protection from some vaccines can fade. A booster helps “remind” your child’s immune system how to fight the disease, so it is always ready. For example, children should receive a tetanus booster (Tdap) around age 11.
- Yearly: Some viruses change often, so new vaccines are made each year to match them. The flu shot is a good example – it is updated every year to protect against the flu strains that are spreading the most each winter.
Types
Scientists use different methods to make vaccines. The one they choose depends on what they know about the disease it is designed for, like how the germ infects people, how the immune system reacts, where the germ is found, and what kind of germ (or “strain”) it is.
According to the Centers for Disease Control and Prevention (CDC), there are several main types of vaccines used in the United States:
Children who have a weakened immune system, such as after a kidney transplant, should not get live vaccines. Always talk with your healthcare team before getting any vaccine to make sure it is safe for you.
Effectiveness
Vaccines are one of the best ways to keep children healthy. They help your child’s body prepare to fight off germs that can cause diseases like the flu, hepatitis B, pneumonia, or polio.
A vaccine may not always stop your child from getting an infection. But if they do get sick, the vaccine helps their body fight it faster and helps keep them from getting very sick. The goal is to help the immune system work quickly and protect from serious illness – such as needing hospital care, ICU (intensive care unit) care, or even dying from the infection. In other words, vaccines can offer the best possible protection against the worst effects of some infections.
After getting a vaccine, the body needs time to build protection:
- For vaccines that only need one dose, your child is usually protected within a few weeks.
- For vaccines that need more than one dose, your child only gets part of the protection after the first dose. The strongest protection comes a few weeks after the last dose in the series. So, it is important to get all doses on schedule. Skipping or delaying doses can make the vaccine less effective.
How well a vaccine works depends on your child’s immune system. People with a weakened immune system are more likely to get seriously ill from infections. However, their immune system also may not respond as strongly to vaccines. This is why people with weaker immune systems may need extra doses or higher doses of certain vaccines to stay protected.
Your child’s immune system may be weaker if they:
- have been on dialysis for a long time
- are getting chemotherapy
- take anti-rejection medicines, such as after kidney or other organ transplant
- are taking medicine for glomerular disease (like IgA nephropathy, C3G disease, or lupus nephritis) that “calms” the immune system
Not everyone’s immune system is weakened in the same way. Some people have a slightly lower immune response, while others have very little immune protection.
Side effects
Like any medicine, vaccines can cause side effects. Most side effects are mild and short-term. Common side effects include:
- soreness or redness where your child got the vaccine
- mild rash
- low fever
- headache
- feeling tired
These mild side effects are normal and mean your child’s body is learning how to fight the germ and building protection.
Serious side effects are very rare. Call 911 or go to the hospital if your child has:
- hives or swelling of the face or throat
- fast heartbeat
- dizziness or weakness
- trouble breathing
- tingling or weakness in their legs, arms or face (potential signs of a rare nerve condition called Guillain-Barré Syndrome).
If your child has had a serious reaction to one vaccine, it may increase their risk of reacting to another one – but not always.
Extensive research has definitively shown there is no link between vaccines and autism.
If you believe your child was seriously hurt by a vaccine, you may be able to get help from the National Vaccine Injury Compensation Program (VICP). Not all vaccines are covered by this program.
COVID-19 and myocarditis/pericarditis
In very rare cases, some people have had myocarditis (swelling of the heart muscle) or pericarditis (swelling of the lining around the heart) after getting a COVID-19 vaccine in the United States. The CDC and Advisory Committee on Immunization Practices (ACIP) continue to emphasize that the benefits of getting vaccinated are much greater than the small risk of these heart problems. The vaccine helps prevent serious illness, hospital stays, and death caused by COVID-19, including heart problems that can happen from the virus itself.
These side effects are rare, but people (especially males age 12-39) should know what symptoms to look for after vaccination. Call your doctor or get medical help right away if you notice:
- chest pain
- shortness of breath
- fast or pounding heartbeat
If these symptoms happen, they usually appear within one week after COVID-19 vaccination.
Vaccines are a safe and effective way to protect against serious infections. Getting sick naturally can be much more dangerous – even for illnesses that seem mild. Since no one can predict who will get very sick from an infection, vaccines are the best way to protect yourself and the people you care about.
Recommended vaccines for children with CKD
For children (age 18 or younger) with CKD, on dialysis, or who have had a kidney transplant, it’s important to know which vaccines are safe and recommended. Always talk with a healthcare professional about risks and benefits to your child before getting a vaccine.
Be sure to tell the vaccine provider if your child:
- is on dialysis
- has had a kidney or other organ transplant
- has ever had a serious reaction to a vaccine
The information below lists the vaccines that most children and adolescents with kidney disease may need, based on the best available evidence and CDC guidance as of October 2025.
Additional considerations
Special considerations for children with a kidney transplant
Children who have had a kidney transplant take anti-rejection medicines to help keep their new kidney healthy. These medicines weaken the immune system, which means live vaccines are not safe for them. These include the nasal flu spray, MMR, and chickenpox (varicella) vaccines. Always talk with your child’s healthcare provider before your child gets any vaccine. Your healthcare team can help you know which vaccines are safe and recommended and when they should be given.
Finding vaccines
Talk with your child’s healthcare team first to learn which vaccines are recommended for your child. You can usually get vaccines at:
- the clinic where you receive regular medical care
- your local pharmacy
- your public health department
Some local health agencies or hospitals also hold special vaccine clinics during the year.
Cost of vaccines
The cost of vaccines can vary, but most are covered by insurance or available at no cost through special programs.
Private insurance usually covers routine childhood vaccines. The Vaccines for Children (VFC) Program provides free vaccines for children who meet at least one of the following crtieria:
- do not have insurance
- have Medicaid (or are eligible for Medicaid)
- have insurance, but either the policy does not cover certain vaccines, or the parents cannot afford the cost
- are of American Indian or Alaskan Native heritage
The VFC 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 also covers routine childhood vaccinations at no cost for eligible children. Check with your child’s healthcare provider or your state Medicaid office to confirm coverage and find out where your child can get vaccinated.
In some states, you may need a prescription from your child’s healthcare provider before your child can:
- get a vaccine at a pharmacy, or
- have the cost covered by Medicaid or other insurance
Your healthcare provider or state Medicaid office can tell you about any local rules or requirements.
Questions for your healthcare team
- Which vaccines should my child get because of their kidney disease?
- Does my child need any other vaccines based on their other health conditions or risk factors?
- Where can I find trustworthy information about vaccines?
- Would you consider my child to be “immunocompromised” (having a very weak immune system)?
- [If your child missed any doses] Can you please recommend a catch-up schedule for my child’s recommended vaccines?
More resources
- Centers for Disease Control and Prevention (CDC)
- CDC: Safety Information by Vaccine
- CDC: Diseases the Vaccines Help Protect Against
- CDC: Before, During, and After Shots
- CDC: Explaining How Vaccines Work
- CDC: Keeping Track of Records
- Vaccines for Children (VFC) Program: Information for Parents
- VaccineInformation.org
- Where to Get Vaccinated
