Diabetes Forecast

Important Vaccines for People With Diabetes


Studies have shown that the white blood cells in people with both type 1 and type 2 diabetes don’t function as well in attacking foreign bacteria, says William Schaffner, MD, medical director of the National Foundation for Infectious Diseases and an infectious disease specialist at Vanderbilt Medical Center in Nashville, Tennessee. This is why it’s important for people with diabetes to receive vaccinations for extra protection. If you follow the American Diabetes Association 2016 Standards of Medical Care in Diabetes and get your vaccines on schedule, you can prevent illnesses such as the flu, pneumonia, and hepatitis B.

Influenza (Flu)

Why get it? The flu virus hits hardest those who are over 65, who have a weakened immune system, and/or who have an underlying condition, such as diabetes or heart and lung diseases, says Schaffner. People with diabetes tend to get more-severe cases of the flu and face an increased risk of pneumonia. The flu can also worsen diabetes control. The infection changes your metabolism, which can disrupt glucose control, Schaffner says.

What do I ask for? Most pharmacies and primary care doctors offer this vaccine during flu season for little or no cost—just ask for the flu vaccine. Some experts recommend people over 65 ask for a high-dose flu vaccine, but a standard dose is fine if that is what’s available. A nasal spray flu vaccine also is available and approved for use in people ages 2 to 49, though studies have found it ineffective in children.

How often? This is an annual vaccine. Schaffner says mid-September is the best time to get your flu shot, a few weeks before flu season, which lasts from October to May, with peak times between December and February. It’s better to get a late shot than none at all.

Pneumococcal pneumonia

Why get it? Pneumonia is a lung infection caused by a bacteria, virus, or fungus and is the most common complication of the flu. This vaccine helps protect against pneumococcal bacteria, which can cause blood infections, ear infections, and meningitis, which is a dangerous infection of the lining of the brain and spinal cord. Each of these can be serious enough to put you in the hospital.

What do I ask for? There are two pneumococcal vaccines. The pneumococcal conjugate vaccine (PCV13) protects against 13 types of pneumococcal bacteria. The pneumococcal polysaccharide vaccine (PPSV23) protects against 23 types. All people with diabetes age 2 and older should receive the PPSV23 vaccine. Those 65 years and older should receive both vaccines.

How often? The dose schedule varies depending on your circumstances:

  • If you are younger than 65: one dose of PPSV23
  • If you are 65 or older and received a PPSV23 vaccination in the past: one dose of PCV13 at least a year after your PPSV23 dose and a second dose of PPSV23 at least a year after your PCV13 dose and at least five years after your first PPSV23 dose
  • If you are 65 or older and were not previously vaccinated: one dose of PCV13, followed by a dose of PPSV23 at least a year after your PCV13 dose
  • Hepatitis B

    Why get it? Hepatitis B is a virus that attacks the liver and is transmitted through contact with infected blood and bodily fluid, including during sexual contact. Studies have shown that people with diabetes have higher rates of hepatitis B than those without diabetes. The reason is not fully understood, but it may be due in part to exposure to infected blood through improper use or sharing of lancing devices or needles, says Schaffner. Because of this higher rate of transmission, the hepatitis B vaccine is recommended for all adults with diabetes.

    What do I ask for? Ask your doctor for the hepatitis B vaccine series.

    How often? This is a series of three vaccines. You will get a second dose at one month and a third dose at six months after the first shot.

    In The Know

    Does the flu vaccine make you flu-proof?

    It’s still possible to get the flu, but it will likely be a less-severe infection. The seasonal flu vaccine is based on research indicating the three or four viruses that are most likely to spread and cause illness during the upcoming flu season. Flu viruses are constantly changing, so the vaccine is reviewed each year and updated as needed.

    Extra Protection

    There are several other vaccines the Centers for Disease Control and Prevention recommends for people with diabetes:

    • Tdap: protects against whooping cough, diphtheria, and tetanus
    • Zoster: to prevent shingles in those 60 and older
    • HPV: protects against the sexually transmitted human papillomavirus in men and women and is given up to age 26
    • MMR: helps prevent measles, mumps, and rubella
    • Varicella: protects against the chicken pox

    If you’re unsure which vaccinations you’ve received in the past, it’s a good idea to review your status with your doctor and keep your own record going forward.

    On the Horizon

    A new hepatitis B vaccine is in the research stages and could become available in the next year or so, according to Schaffner. It has a very good track record when tested in people with diabetes and requires only a series of two injections. A two-dose vaccine, rather than three, makes it much more likely that people will get all the shots and have better protection, Schaffner says.

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