Table Below: A compilation of published immunization guidelines from selected countries on the use of the influenza, hepatitis B, and pneumococcal vaccines in patients with CKD is provided. The KDIGO co-chairs of the work group examining CKD as a risk factor for infections compiled this table through the assistance of members of the workgroup, the conference participants, and outside colleagues.

Country	Influenza vaccine	Hepatitis B vaccine	Pneumococcal vaccine	Source document (reference)
Belgium	Persons suffering from chronic diseases including that of the kidneys.	Candidates for or patients already treated by kidney replacement therapy.	High-risk persons aged > 45 years; renal patients (not further specified) and transplant recipients are considered as high-risk persons.	Scientific Institute of Public Health [1]
Brazil	Patients with chronic renal disease, and transplant recipients	Patients on hemodialysis or awaiting initiation of hemodialysis; transplant recipients	Patients with chronic renal disease, and transplant recipients	Centro de Vigilancia Epidemiologica - Divisão de Imunização - Sao Paulo [2]
Canada	Persons aged ≥ 65 years; adults and children with chronic conditions, such as diabetes mellitus and other metabolic diseases, cancer, immunodeficiency, immunosuppression (due to underlying disease and/or therapy), renal disease, anemia, and hemoglobinopathy	Hemodialysis patients (40 µg of vaccine antigen per dose should be used)	Persons ≥ 75 years of age; persons aged 65-74 years with chronic renal diseases/chronic renal insufficiency; persons aged ≥ 2 years of age with nephrotic syndrome, or upon commencement of dialysis; induced immunosuppression for organ transplant or post-transplantation (bone marrow or stem cell and solid organ transplants)	Health Canada [3]
Iceland	Yearly vaccination recommended for persons aged > 60 years, children and adults suffering from chronic diseases of the heart, lungs, kidneys and liver, and persons with diabetes mellitus, malignancies or other immunosuppressive diseases.	Patients on hemodialysis	Persons aged > 60 years, persons with chronic disease of the heart, lungs, kidneys and liver, persons with diabetes, malignancies and other immunosuppressive diseases. Vaccination generally recommended every 10 years, but every 5 years in patients with immunosuppressive diseases.	Icelandic Surgeon General [4]
India	In special circumstances	At birth	In special circumstances	Indian Medical Association [5]
Japan	Yearly vaccination recommended for persons aged ≥ 65 years or 60-64 years with activities of daily living that are severely impaired by disorders of heart, kidney or lung.	Mandatory for dialysis patients	Mandatory vaccination (once during lifetime). Special recommendation for aged persons, persons aged > 2 years with chronic heart, liver, lung, or kidney disease, and persons with diabetes or immune deficiency.	Japanese Infectious Disease Surveillance Center [6]
South Africa	All persons over the age of 65 years; persons (adults or children) receiving regular medical care for conditions such as chronic pulmonary and cardiac disease, chronic renal diseases, diabetes mellitus and similar metabolic disorders, and individuals who are immunosuppressed (including HIV-infected persons with CD4 counts above 200/ml).	National policy on childhood vaccination for hepatitis B; adults in high-risk occupations; and patients on hemodialysis.	Persons aged ≥ 65 years; persons aged ≥ 2 years with chronic renal failure, nephrotic syndrome, organ or bone marrow transplants and on immunosuppressive therapy.	National Institute for Communicable Diseases [7]; Pulmonology Society Working Group [8]; and South African Renal Society [9]
United Kingdom	Chronic medical conditions (respiratory, heart, renal, liver disease, and diabetes)	Hemodialysis patients	Chronic medical conditions (respiratory, heart, renal, liver disease, and diabetes)	Department of Health [10]
USA	Persons aged ≥ 65 years; adults and children who have required regular medical follow-up or hospitalization during the preceding year because of chronic metabolic diseases (including diabetes mellitus), renal dysfunction	Universal vaccination of infants; Hepatitis B vaccination is recommended for all children and adolescents aged < 19 years; persons aged ≥20 years pre-dialysis (immunogenicity might depend on degree of renal insufficiency) or dialysis-dependent	Persons aged 2-64 years who have chronic illness; immunocompromised persons aged ≥ 2 years, including persons with chronic renal failure and nephrotic syndrome.	Advisory Committee on Immunization Practices of the Centers for Disease Control and Prevention [11]
Acknowledgments: The workgroup co-chairs wish to thank members of the workgroup, the entire conference participants, and outside colleagues for their valuable input, including Drs. Sanjay K. Agarwal (India), Sharon P. Andreoli (USA), Emmanuel Burdman (Brazil), Barbara Fivush (USA), Ólafur Skúli Indriðason (Iceland), Kunitoshi Iseki (Japan), Vivekanand Jha (India), Gillian de Jong (South Africa), Ivor J. Katz (South Africa), Jeffrey D. Leiser (USA), Charlie Tomson (United Kingdom), Yusuke Tsukamoto (Japan), and Raymond Vanholder (Belgium). Reference List Scientific Institute of Public Health. http://www.iph.fgov.be/flu/NL/HGR_Influenza.pdf 2006. Ref Type: Report Accessed October 25 2006. Centro de Vigilancia Epidemiologica - Divisão de Imunização - Sao Paulo. 2006. Ref Type: Electronic Citation Accessed October 24 2006. Health Canada. 2006. Ref Type: Electronic Citation Icelandic Surgeon General. http://landlaeknir.is/template1.asp?pageid=202 10-19-2006. Ref Type: Electronic Citation Indian Medical Association. http://www.imanational.com/PH0.htm 10-19-2006. Ref Type: Electronic Citation Japanese Infectious Disease Surveillance Center. http://www.mhlw.go.jp/bunya/kenkou/kekkaku-kansenshou09/pdf/01.pdf 10-19-2006. Ref Type: Electronic Citation Schoub B: Recommendations pertaining to the use of viral vaccines: influenza 2006. S Afr J Med 96:103, 2006 SAMA-SA Pulmonology Society Working Group: Adult pneumococcal vaccination guideline. S Afr Med J 89:1222-1230, 1999 Moosa M, Naicker S, Naiker I et al.: Guidelines for the optimal care of patients on chronic dialysis in South Africa. SARS Chronic Dialysis Guidelines, 2005 Department of Health. Immunisation Against Infectious Disease 1996 - "The Green Book". 1996. Ref Type: Report Centers for Disease Control and Prevention. Advisory Committee on Immunization Practices. http://www.cdc.gov/nip/publications/acip-list.htm#Vaccine 10-19-2006. Ref Type: Electronic Citation