High-Dose Versus Standard-Dose Influenza Vaccine in Hemodialysis Patients

High-Dose Versus Standard-Dose Influenza Vaccine in Hemodialysis Patients: Butler et al1 found no significant difference in mortality and influenza-related morbidity with high-dose vaccine (HDV) as compared with standard-dose vaccine (SDV) in an analysis of more than 250,000 US Renal Data System patients. Analyses were adjusted for an extensive list of comorbid conditions, but with only 2.6% receiving the HDV, we cannot help but wonder whether there is residual confounding. Our analysis of approximately 10,000 patients from a national dialysis provider2 showed a 7% relative risk reduction in all-cause hospitalization with HDV versus SDV in the 2016 to 2017 season and a trend in the same direction in 2015 to 2016.