Vaccines for persons with diabetes

Persons with diabetes are at increased risk for developing infectious diseases. They are more likely to die from infections because high blood glucose levels compromise the function of the immune system. The American Diabetes Association makes specific recommendations on the vaccinations person with diabetes should receive. Those recommendations are summarized below.

Flu Shots: Annual vaccination against influenza is recommended for all persons with diabetes that are 6 months of age and older. Use of the vaccine reduces hospitalizations and deaths from the flu. It takes 6 weeks for the vaccine to be fully effective. Therefore, the vaccine should be received as soon as it becomes available in the fall so that it is fully effective by the peak of the flu season, which occurs in December and January. Vaccines are being developed that will not require annual dosing.

Pneumonia vaccines: Pneumonia is an infection of the lungs that is more common and severe in persons with diabetes. Persons with diabetes are more likely to have pneumonia move from their lungs into their blood stream causing a condition known as sepsis. This complicated form of pneumonia has a high mortality rate. Up to 50% of person with diabetes that have this form of infection die from it. Pneumonia vaccine recommendations are based on the patient’s age. Children under the age of two years should receive Prevnar 13. This form of the vaccine give protection against the 13 most common strains of pneumococcal pneumonia – the bacteria responsible for the largest number of cases of pneumonia.

People with diabetes ages 2 through 64 should receive Pneumovax 23. This form of the pneumonia vaccine offers protection against 23 of the most frequent and severe forms of the pneumococcal bacteria. Patients with chronic lung disease, had their spleen removed or who take medicines that suppress the immune system should receive a booster every 5 years. Check with your health care provider.

After age 65, an additional dose of the Pneumovax 23 vaccine is recommended. If there is no previous history of pneumonia vaccination a dose of Pneumovax 23 should be given followed one year later by a dose of the Prevnar 13. The combination of the two vaccines should provide lifelong protection.

Hepatitis B: Hepatitis is a chronic liver infection that can lead to cirrhosis – chronic liver failure. Persons with diabetes are more prone to contract hepatitis B because they are at increased risk of coming into contact with the blood of others with hepatitis B. The 2- or 3-dose series of hepatitis B vaccine should be received by all persons with diabetes between the ages of 19 and 59 years. If the vaccine is not received until age 60 or older, the 3-dose series is recommended.

In addition to these specific recommendations, persons with diabetes should also receive all generally recommended vaccinations. The Centers for Disease Control and Prevention have detailed information on their website concerning childhood and adult vaccinations. Vaccinations for persons with diabetes is even more important than for the general population.

Sam Abbate is a Valley physician working in Wasilla.