Diabetes Forecast

The Healthy Living Magazine

Top 3 Vaccinations for Adults With Diabetes

Be safe: Get a flu shot and these other vaccinations

By Mark Harmel, MPH , , ,
doctor giving senior citizen a vaccine shot


We hear a lot about vaccination shots for children, but it turns out that adults need vaccinations, too. Getting vaccinations as recommended is even more important for people with all forms of diabetes because they are more likely to be infected and more susceptible to complications of flu and pneumonia, says William Schaffner, MD, professor of preventive medicine at Vanderbilt University School of Medicine in Nashville, Tenn., and the immediate past-president of the National Foundation for Infectious Diseases.

Schaffner and the American Diabetes Association Professional Practice Committee, which writes the yearly Standards of Medical Care in Diabetes, agree that adults with diabetes should be current with three different types of vaccinations. Schaffner suggests a fourth to consider as well. Let’s start with the most important yearly vaccination—the flu shot.

1. Influenza

“The flu can be very deceptive,” warns Schaffner. “It can range from a mild illness—not much worse than a bad cold—to a really serious winter virus that can make you very sick. Flu alone can take an otherwise healthy person with or without diabetes and put them in bed and indeed into the emergency room within 24 to 48 hours, and it accounts for 200,000 hospitalizations with about 36,000 deaths each year.”

Because the flu virus changes every year, it’s a good idea to create a yearly ritual of getting the shot at the beginning of each flu season (typically September). This provides the greatest protection because it will cover the entire four- to six-month-long flu season.

Schaffner recommends expanding your circle of protection by vaccinating the entire family as soon as the shots and nasal sprays become available in September or October. This helps prevent others from bringing home the disease.

People in higher-risk groups tend to get first dibs on the shots (when supplies are scarce) and include people with diabetes, pregnant woman, those who live in a nursing home or long-term care facility, and obese people with a body mass index (BMI) of 40 or more. Flu should not be taken lightly, according to Schaffner. “Flu affects the bronchial tubes and lungs, causing inflammation that can then lead to bacterial pneumonia.” Which leads us to the next shot.

2. Pneumococcal Infection

“Pneumococcal” (noo-muh-KOK-uhl) refers to the bacteria that is the most common cause of the lung infection known as pneumonia. The vaccine against this bacteria is often called the pneumonia vaccine simply because it’s easier to say. But the vaccine also protects you from bloodstream infections and meningitis caused by pneumococcal bacteria.

People with diabetes are more likely to become infected with pneumococci, even when their blood glucose is under control. The name is hard to say, but the vaccine is easy to take because only a single dose is needed. For those 65 and older, a second dose of vaccine is recommended if it has been five years or more since your first dose.

3. Hepatitis B

This newest entry on the list of recommended vaccinations is the “big surprise not only to people with diabetes, but to their providers as well. It was added after the Centers for Disease Control and Prevention [CDC] took a look at hepatitis B and discovered that people with diabetes had a higher risk of getting hepatitis B than others the same age without diabetes,” Schaffner says.

This vaccine protects against hepatitis B virus infection, which can cause liver disease and liver cancer. It is currently recommended for adults up to age 59, and can be considered for those 60 and older who reside in group living situations because, according to Schaffner, there have been outbreaks of this serious infection in hospitals, nursing homes, and assisted living facilities.

Schaffner adds a fourth shot to his list, Tdap (tetanus, diphtheria, and pertussis), because whooping cough (pertussis) is coming back and “none of us wish to be the transmitter of whooping cough to a young infant.” Whooping cough can kill the very young, and we know that infants are most likely to acquire whooping cough from adults. The Tdap is suggested for pregnant women during each pregnancy (best at 27 to 36 weeks) and any adult who is not sure if he or she has had the vaccine. This is followed by a tetanus and diphtheria booster every 10 years after.

Extra Shot OK?

The every-year flu shot may be easy to recall, but what if you don’t have a record of your other vaccinations? Your health care provider may have your vaccination history (or could do a blood test to check). If there is uncertainty, however, William Schaffner, MD, suggests “when in doubt, immunize.” He says that there is no risk in getting an extra dose because it will provide you with the desired protection.

Finding and Paying for the Shots

Free vaccinations are more available this year for insured patients because of the focus on prevention in the newer health insurance plans. Some work sites offer free immunization programs. And insurance may cover shots that are available at large pharmacy chains and supermarkets. Local health departments are another source of free or cheap vaccinations for people without insurance.

More Resources

To learn more about what vaccines you may need, go to, the site run by the nonprofit National Foundation for Infectious Diseases. You can also take a quick interactive test to find out which vaccines may be recommended for you at On that government site, you can plug in answers about your sex, age, and risk factors and it provides a list of vaccines to consider and a link to a health map to find locations for shots. Of course, you can always go to your own health care provider for the vaccinations as well.

“Vaccinations for adults are as important as vaccinations for children,” says William Schaffner, MD, a professor of preventive medicine at Vanderbilt University School of Medicine in Nashville, Tenn. “We all should take care and take advantage of the prevention that vaccinations can provide,” he says. “Anything that we can do to prevent infections is, of course, a good thing and will contribute to the health of people with diabetes.” Parents, visit to see vaccination schedules for kids by age.

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