Implementation and Outcomes of a Pharmacist-Led Vaccination Program in Incident Hemodialysis Patients: Single-Center Experience from Singapore

Background: Patients initiating hemodialysis are at increased risk of vaccine-preventable infections. To address this, a pharmacist-led vaccination program was implemented at Changi General Hospital aimed at improving immunization rates among incident hemodialysis patients. Methods: We retrospectively analyzed pneumococcal and hepatitis B vaccination uptake and outcomes in patients who started dialysis between 2019 and 2022. Results: A total of 381 patients initiated dialysis during this period (mean age 62.2 ± 12 years; 61% male). Diabetic kidney disease accounted for 62% of cases. Among 262 patients at risk for Hepatitis B, only 38% received the complete three-dose primary series, 27% received fewer than three doses, and 34% remained unvaccinated. Of those who completed the full series, only 51% achieved seroprotective antibody levels (anti-HBs >10 IU/L), suggesting suboptimal immunogenicity. Similarly, pneumococcal vaccination rates were low, with only 42% of 322 at-risk patients receiving the vaccine. Importantly, pneumonia-related hospitalizations were significantly reduced in vaccinated individuals (2.17%) compared to unvaccinated ones (7.45%, p = 0.002), underscoring the protective benefit of vaccination. Conclusion: Our findings highlight critical gaps in vaccine coverage and immune response in dialysis patients. Further review of the delivery of our care model, potentially involving our renal nurses, is key to enhance vaccine delivery and reduce infection-related morbidity in this high-risk population.