Vaccinations, Immunizations and Diabetes

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.

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.

RFS - immunizationsThere is sufficient evidence that people with diabetes generally have appropriate immune responses to benefit from a host of vaccinations.

Types of Vaccinations and Immunizations

Influenza Vaccine.  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 Vaccine.  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. Diphtheria spreads when germs pass from one person to the nose or throat of others.If you are prone to chronic wounds because of your diabetes you are at special risk for tetanus.

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.

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