ALB and congestive heart failure: As factors contributing to this maximum antibody titer in HD patients, Agur et al. identified younger age, higher albumin levels, lower intravenous iron doses, and BMI less than 30 [14] and Lacson et al. also identified women, younger age, immunosuppressed status due to disease or medications, chronic heart failure, and history of other vaccinations or hospitalizations before and after vaccination [15].