Patients with end-stage renal disease (ESRD) are considered a high-risk population for hospitaliza-tion and death from infections such as influenza and bacterial pneumonia. During the past 2 decades, administration of both the influenza and pneumococcal vaccines has become routine practice at dialysis clinics in the United States. Now considered a standard of care, surprisingly little information is available about the vaccines' effectiveness. To date, there has been no controlled clinical trial testing their efficacy in the dialysis population. We in the nephrology community have put our faith in observational studies to determine the magnitude of benefit from these preventative measures.
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