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Vaccinations - Immunizations and Diabetes
People with diabetes often have problems with their immune systems and are at increased risk for death from infection that might be considered minor for people without diabetes. Studies show people with diabetes, especially those with cardiac and renal disease are at high risk for complications, hospitalization, and death from influenza and pneumococcal disease.
There is sufficient evidence that people with diabetes generally have appropriate immune responses to benefit from a host of vaccinations.
If you have diabetes, take extra care to keep up-to-date on your vaccinations (also called immunizations). Vaccines can prevent illnesses that can be very serious for people with diabetes.
Influenza (the flu) is not just a bad cold. It’s a potentially serious illness that can lead to pneumonia and even death for people with diabetes. The flu spreads when influenza viruses pass from one person to another through physical contact, or via sneeze or cough. Signs of the flu may include sudden high fever, chills, body aches, sore throat, runny nose, dry cough, and headache.
The flu is a serious illness that can put you in the hospital.
Everyone with diabetes—even pregnant women—should get a yearly flu shot. The best time to get one is between September and mid-November, before the flu season begins. Don’t get a flu shot if you are allergic to eggs. The nasal spray vaccine is not safe for people with diabetes.
This vaccine is fully covered under Medicare Part B.
Pneumococcal disease is a major source of illness and death. It can cause serious infections of the lungs (pneumonia), the blood (bacteremia), and the covering of the brain (meningitis).
People with diabetes are about three times more likely to die with flu and pneumonia. Yet only one-third of them ever get a simple, safe pneumonia shot.
People with diabetes need to get vaccinated with the pneumococcal polysaccharide vaccine (PPSV23). PPV can be given at the same time as the flu vaccine—or at any time of the year. Most people only have to take PPV once in their life. People under 65 who have a chronic illness such as diabetes or a weakened immune system should ask their doctor about getting another shot 5-10 years after their first one. Adults with certain high risk conditions also need vaccination with PCV13.
This vaccine is fully covered under Medicare Part B.
Meningococcal (MCV4, MPSV4)
You need this vaccine if you are 19 – 21 and a first-year college student living in a residence hall and you either have never been vaccinated or were vaccinated before age 16.
Tetanus/Diphtheria (Td) Toxoid
Tetanus (or lockjaw) and diphtheria are serious diseases. Tetanus is caused by a germ that enters the body through a cut or wound. If you are prone to chronic wounds because of your diabetes you are at special risk for tetanus.
Diphtheria spreads when germs pass from one person to the nose or throat of others.
You can help prevent tetanus and diphtheria with a combined shot called Td toxoid. Most people get Td toxoid as part of their routine childhood vaccinations, but all adults need a Td booster shot every 10 years. Women need to be vaccinated during each pregnancy.
Consult your healthcare provider if you are over 40 and haven’t had at least 3 tetanus and diphtheria shots sometime in your life or you have a deep or dirty wound.
Other vaccines may be given at the same time as Td toxoid.
Hepatitis B Vaccine
Up to age 60, people with diabetes have twice the risk of hepatitis B as those without diabetes. Yet only 17% of those living with diabetes (and 26% of those without diabetes) have been fully vaccinated against hepatitis B.
The Advisory Committee on Immunization Practices (ACIP) strongly recommends the hepatitis B vaccine for diabetes patients under age 60 who have not been fully vaccinated. It also urged hepatitis vaccination of some older diabetes patients.
The hepatitis vaccine is most effective in young adults. If they haven't already been vaccinated, people should get the hepatitis B vaccine as soon as they learn of their diabetes diagnosis. The three – four dose series offers protection that usually lasts a lifetime.
Diabetes patients over age 60 may also be at increased risk. Carolyn Bridges, associate director for adult immunizations at the National Center for Immunization and Respiratory Diseases at the C.D.C. said health officials had recorded hepatitis outbreaks at nursing homes among people who shared devices that test blood sugar levels.
You may need vaccines to protect you against other illnesses. Ask your health care provider if you need any of these:
Human Papilloma Virus – The HPV virus puts women at greater risk for cervical cancer and men at greater risk for oral cancers. You need this vaccine if you are a woman age 26 or younger or a man age 21 or younger. Men age 22 through 26 with a risk condition also need vaccination. Any other men age 22 through 26 who want protection from HPV may receive it, too. The vaccine is given in 3 doses over 6 months
Measles/Mumps/Rubella vaccine - you need a vaccine if you were born later than 1957. You also may need a booster.
Hepatitis A vaccine - You need this vaccine if you have a specific risk factor for hepatitis A virus infection or simply want to be protected from this disease. The vaccine is usually given in 2 doses, 6 months apart.
Varicella (chicken pox) vaccine - If you are an adult born in the U.S. in 1980 or later, and have never had chickenpox or the vaccine, you should be vaccinated with this 2-dose series.
Zoster (shingles vaccine) - After you get chickenpox, the virus remains inactive in certain nerves in the body. Shingles occurs after the virus becomes active again in these nerves years later.
Shingles may develop in any age group, but you are more likely to develop the condition if:
• You are older than 60
• You had chickenpox before age 1
• Your immune system is weakened by medications or disease such as diabetes.
A herpes zoster vaccine is available. It is different than the chickenpox vaccine. Older adults who receive the herpes zoster vaccine are less likely to have complications from shingles.
The United States Advisory Committee on Immunization Practices (ACIP) has recommended that adults older than 60 receive the herpes zoster vaccine as part of routine medical care.
Vaccines required for travel to other countries.
How to Get More Information
Call the immunization program in your state health department to find out where you can get vaccinations in your area. Keep your vaccination records up-to-date so you and your health care provider will know what vaccines you may need. You can record this information on the record sheets.
For more information on vaccination, call the CDC National Immunization Hotline at 1-800-CDC-INFO (English and Spanish). This is a toll-free call. firstname.lastname@example.org
National Center for Chronic Disease Prevention and Health Promotion,
Division of Diabetes Translation
Immunization Action Coalition
US National Library of Medicine
United States Advisory Committee on Immunization Practices
Updated July 2, 2013
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