Brendan Bowman, MD, vice president of medical affairs for DaVita Kidney Care

As nephrologists, we are on the front lines of managing one of the most complex and vulnerable patient populations. Our patients with end stage kidney disease (ESKD) are already battling a chronic condition that places immense stress on their bodies and weakens their immune systems.

This is why, as we enter flu season, the conversation about influenza vaccination is not just a routine check-in — it’s a critical and potentially life-saving discussion we must have with every patient.

For our patients, the flu is often far more than a few days of body aches and a cough. It can be a direct threat that could lead to severe symptoms, hospitalization, and even death. Data consistently shows that patients with ESKD are at a significantly higher risk for flu-related complications compared to the general population.¹ According to the U.S. Centers for Disease Control and Prevention (CDC), people with kidney disease are at higher risk than the general population for serious complications — hospitalization, ICU admission, or even death. From 2010 to 2019, influenza-related hospitalization rates were significantly higher for patients with ESKD compared with patients without ESKD. Age-adjusted mortality was consistently higher in those with ESKD (2.25.% compared to 1.38%).² In addition, we know from recent statistics that the unvaccinated bear disproportionate risk. The CDC’s review of the most recent flu season demonstrated that, as in prior years, 2/3 of hospitalizations are among the unvaccinated3— surely an opportunity for healthcare providers.

These aren't just statistics; they are the lived realities of our patients and the families we serve.

As clinicians, we are not just treating kidney disease; rather, we aim to be advocates for our patients' holistic health and well-being. This requires a proactive approach to preventive care. The flu vaccine is, without a doubt, one of the most powerful tools in our preventive arsenal. It is safe, effective and readily available, offering a strong line of defense against a viral threat in in this most vulnerable population.

However, simply offering the vaccine is often not enough. Many of our patients may be hesitant or lack access to information about the flu shot. There are various reasons why they may have developed concerns about its effectiveness, potential side effects or its safety. This is where our role as educators becomes paramount.

We must use our position of trust to provide clear, accurate and compelling information to inform shared decision making with our patients

Our conversations should be direct and empathetic. We must explain why the vaccine is so important for them. We can frame the discussion around protecting their quality of life, preventing a feared hospitalization that could interrupt their dialysis schedule, and safeguarding their ability to spend time with loved ones — particularly around the holidays. It is important to build rapport and develop shared goals when it comes to managing their health.

Here are a few strategies that may be effective in educating and empowering patients:

• Make it a Priority: The flu vaccine should be a standard part of the pre-respiratory virus season care plan for every patient. It should be discussed during scheduled visits to promote understanding and encourage patients to receive the vaccine.
• Address Misconceptions Head-On: Actively ask patients if they have any concerns or questions about the vaccine. Addressing concerns about the flu shot causing the flu or being unsafe is crucial for building trust and equipping patients to make decisions for their health.
• Work with the Clinical Team: The entire care team — patient care technicians, nurses, social workers and dietitians — should be empowered to reinforce the message. A unified front provides a more powerful and consistent message that resonates with patients. As you know, DaVita centers offer flu shots on site, offering additional convenience to critical, preventive care.

As nephrologists, we bear the responsibility of protecting our patients from both their chronic condition and external threats that risk compromising their health. The flu vaccine is a simple, yet profoundly impactful intervention. By prioritizing vaccinations, educating our patients, and addressing their concerns, we have the opportunity to significantly reduce the burden of preventable hospitalizations and, most importantly, help our patients live healthier, more complete lives.

Let's make this flu season one defined by prevention, not reaction.

Brendan Bowman, MD, is vice president of medical affairs at DaVita Kidney Care. At DaVita, Dr. Bowman leads dialysis quality and safety efforts and is the physician executive for the Patient Safety Organization (PSO).