People with diabetes, especially those who are not vaccinated, are vulnerable to adverse health outcomes from communicable diseases.
The American Diabetes Association’s Standards of Care provides updated recommendations for routine vaccinations for people with diabetes. By using a person-centered team care approach, healthcare professionals can support the people they see to help increase their understanding of and access to recommended vaccinations.
Influenza
The flu can be serious for anyone. People living with diabetes or other chronic health conditions are at higher risk for serious flu complications. For people living with diabetes, having the flu can also make blood glucose harder to manage.
Beyond people living with diabetes, the following also experience higher risk with the flu:
- People with heart disease
- Smokers and those with chronic lung disease
- People who have an impaired immune system, like those going through chemotherapy or who are organ donation recipients
- Very young children
- People living in very close quarters, such as college dorms, military barracks, or nursing homes
In general, every person with diabetes needs a flu shot each year, ideally before flu season. Talk with the people you treat about getting a flu shot. Flu shots do not give 100% protection, but they do make it less likely for individuals to catch the flu for about six months from the time of vaccination.
COVID-19
For people living with diabetes, COVID-19 infection can be more serious and can carry a higher risk for hospitalization and death. Vaccination can prevent serious outcomes. COVID-19 vaccination is routinely recommended for children aged 6-23 months and adults 65 years and older. All people 6 months and older with diabetes should receive the COVID-19 vaccine as well. For most people, an annual vaccination is recommended after the initial series, but for those 65 years and older, the vaccine is typically given every 6 months.
Respiratory Syncytial Virus (RSV)
The risk of severe RSV illness is higher for older adults and people with certain underlying health conditions. Severe RSV illness can lead to hospitalization and, in some cases, death.
The Centers for Disease Control and Prevention (CDC) recommends RSV vaccination for all adults ages 75 and older. Adults ages 50 to 74 at increased risk for severe RSV illness should also be vaccinated. This includes people with diabetes complicated by chronic kidney disease, neuropathy, retinopathy, or other end-organ damage.
Pneumonia
People living with diabetes are at increased risk for pneumococcal pneumonia and severe complications from this illness. For children under 5 years and people 50 years or older, routine pneumonia vaccination is indicated. People between the ages of 5 and 49 years with additional risk factors, including those with diabetes, should also be vaccinated. There are several types of pneumococcal vaccines. Depending on the individual’s age, vaccine history, and health history, you may recommend one or more pneumococcal vaccines. If more than one type of pneumonia vaccine is recommended, they are usually separated by one year.
Hepatitis B
Hepatitis B infection is common and extremely transmissible through contact with blood or other bodily fluids. People living with diabetes, especially those using insulin, may be at higher risk of infection due to exposure risks inherent with insulin delivery and glucose testing equipment. They may also be at higher risk of chronic infection and complications from the virus. The hepatitis B vaccine series is routinely recommended for people 59 years or younger. People age 60 and older should be vaccinated depending on your determination of risk level and the individual’s needs and values. The series is two, three, or four doses depending on the product used.
Tetanus/Diphtheria/Pertussis (Tdap)
Tdap vaccination is recommended for all people every 10 years once the primary series is completed. People living with diabetes are at higher risk for tetanus infections, especially if they have frequent hospital visits or open wounds.
Shingles
The Zoster two-dose vaccination series is recommended for adults 50 years and older to prevent shingles and its sequalae, including post-herpetic neuralgia. People living with diabetes are at higher risk of hospitalization, neuropathy, and slower healing due to a weakened immune system.
