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Prepare for COVID-19 Season: 6 Facts People With Kidney Disease Should Know

Medically reviewed by Elizabeth Cueto, M.D.
Written by Ted Samson
Posted on October 29, 2025

If you’re living with kidney disease, staying protected against COVID-19 continues to matter — especially as new variants circulate. The U.S. Food and Drug Administration (FDA) has approved a new set of COVID-19 vaccines for the 2025-2026 season, and the Centers for Disease Control and Prevention (CDC) have released updated vaccine guidance.

🗳️ Have you gotten the COVID-19 booster this season?
Yes, I have gotten it.
No, but I plan to.
No, and I’m not sure if I will.
No, and I don’t plan to.

Here’s what you should know about this year’s booster, how it works, who qualifies, and how to make a plan with your care team.

1. New Boosters Target the LP.8.1 Variant This Season

The COVID-19 vaccines are reformulated each year to better match the most commonly circulating virus strains. For the 2025-2026 season, the FDA directed vaccine manufacturers to update their formulas using a monovalent JN.1 lineage, specifically the LP.8.1 strain.

The FDA has approved 2025-2026 booster formulas for:

  • Pfizer’s Comirnaty — A messenger RNA (mRNA) vaccine for people ages 5 to 64 years with at least one condition that raises the risk of severe COVID-19, and for all adults 65 and older
  • Moderna’s Spikevax — An mRNA vaccine for people ages 6 months to 64 years with a high-risk condition, and all adults 65 and older
  • Moderna mNexspike — A lower-dose mRNA vaccine for people ages 12 to 64 years with a high-risk health condition, and all adults 65 and older
  • Novavax’s Nuvaxovid — An adjuvanted, protein-based vaccine for people ages 12 to 64 years with a high-risk health condition, and all adults 65 and older

How Are the Boosters Different?

The main difference is how they’re made. Pfizer and Moderna use mRNA technology, which gives your cells instructions to make a harmless piece of the virus so your immune system learns to fight it. The Novavax vaccine is protein-based (a more traditional vaccine type). It delivers a purified piece of the virus protein with an adjuvant to boost your immune response.

For most people, any of the three options offer similar protection against severe illness. All are approved for high-risk groups, including people with kidney disease.

2. People With Kidney Disease May Be at Higher Risk for Severe COVID-19

COVID-19 doesn’t just affect the lungs. It can trigger widespread inflammation and disrupt how the immune system works, which may lead to complications throughout the body. For people living with chronic kidney disease (CKD), end-stage kidney disease, or those who have received a kidney transplant, the impact can be more serious.

People with kidney disease may be at higher risk for severe illness from COVID-19 if:

  • They are on dialysis — Dialysis can weaken the immune system, making it harder to fight infections. It also requires frequent trips to healthcare facilities where exposure risk may be higher.
  • They have received a kidney transplant — Antirejection medications (immunosuppressants) are essential but lower the immune system’s defenses, increasing the risk of infections and reducing vaccine effectiveness.
  • They take immune-suppressing medications — This includes corticosteroids or drugs used to manage autoimmune diseases affecting the kidneys. These medications can weaken the body’s ability to fight off infections.
  • They have other health conditions — Conditions like diabetes, heart disease, or obesity are more common in people with kidney disease and are known to increase the risk of severe COVID-19 complications.

Can COVID-19 Be Cured?

While most people recover fully from a COVID-19 infection, some develop long COVID, a condition where symptoms persist or reappear weeks or even months after the initial infection. These may include fatigue, brain fog, shortness of breath, and joint pain.

There are treatments available for COVID-19, including antiviral medications like nirmatrelvir/ritonavir (Paxlovid), remdesivir (Veklury), and molnupiravir (Lagevrio). These treatments work best when started early — ideally within the first few days of symptoms.

Not everyone can take these medications. They may interact with other prescriptions or be unsafe for people with certain health conditions. Your doctor can help determine whether one of these treatments is right for you.

3. Health Experts Agree COVID-19 Vaccines Are Safe for People With Kidney Disease

Health experts strongly recommend that people living with kidney disease — including those on dialysis or with a kidney transplant — stay up to date with their COVID-19 vaccines. This is especially important if they are taking immunosuppressive medications or have other risk factors for severe illness.

According to the National Kidney Foundation and American Kidney Fund, vaccination is the best way to reduce the risk of serious illness, hospitalization, and long COVID. While kidney transplant recipients and those on immunosuppression may have a reduced immune response to the vaccine, the benefits still far outweigh the risks.

Experts recommend that people with kidney disease:

  • Get the COVID-19 vaccine when eligible — Vaccines are safe for people at all stages of kidney disease, those on dialysis, and transplant recipients.
  • Talk to your kidney care team about timing — Your doctor may recommend additional doses or adjusting the schedule based on your transplant status, dialysis routine, or medications.
  • Know that the COVID-19 vaccines are safe and not live — Vaccines such as Pfizer, Moderna, and Novavax do not contain the live virus and cannot cause COVID-19.
  • Understand that you may need additional doses — People who are moderately or severely immunocompromised, such as kidney transplant recipients, may need extra vaccine doses to maximize protection.

Separately, the CDC’s Advisory Committee on Immunization Practices (ACIP) has recommended that people decide whether to get a COVID-19 vaccination based on individual decision-making. This approach is similar to guidance around the annual flu shot: You and your doctor can work together to decide what’s right for you.

4. If You’re Living With Kidney Disease, Timing Matters

If you’re considering the updated COVID-19 vaccine, here are important timing steps to talk through with your care team:

  • Ask if you qualify based on your age and health history.
  • Plan around your treatment cycles. Your doctor may recommend receiving the vaccine during a time when your immune system is more stable.
  • Check the timing of your last COVID-19 dose. The updated booster should be given at least two months after your most recent shot.

You can also add extra layers of protection by:

  • Wearing a high-quality mask in crowded or poorly ventilated spaces
  • Practicing frequent and thorough handwashing
  • Improving ventilation by opening windows or using air filters
  • Testing right away if you have symptoms or believe you’ve been exposed

These added steps help lower your risk during treatment weeks or in high-risk situations.

5. Your Doctor Can Help Personalize Your Plan

Every person’s journey is different — and so is their COVID-19 risk. Your care team can help you figure out:

  • When to get the updated vaccine
  • How it fits into your treatment schedule
  • What precautions make the most sense for your lifestyle and health goals

Bringing the FDA guidance with you to your next doctor visit can be helpful. It gives you and your provider a starting point to talk about timing, eligibility, and any questions you may have.

6. Most Insurance Plans Cover COVID-19 Boosters

If the CDC recommends a COVID-19 booster for you, most insurance plans — including Medicare, Medicaid, and private health insurance — will cover it at no cost. This includes the updated vaccines for the 2025-2026 season. Coverage generally applies as long as the shot is given by a provider in your insurance network.

That said, plan details can vary. Call your insurance provider or check your plan’s website to confirm coverage and avoid any surprises. If you don’t have medical insurance, free COVID-19 vaccines may still be available through public health clinics or federal programs.

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On MyKidneyDiseaseTeam, people share their experiences with kidney disease, get advice, and find support from others who understand.

What influenced your choice to get — or not get — the new COVID-19 booster? Let others know in the comments below.

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