Vaccination for Patients with Diabetes

Diabetes mellitus is considered a global pandemic when the proportion of diabetic patients is increasing. According to statistics of the World Diabetes Federation (IDF), the number of people with diabetes in the world in 2015 was 415 million, and is estimated to increase to 642 million by 2040.

Diabetes causes serious consequences including complications on large blood vessels (myocardial infarction, stroke, peripheral artery occlusion), on small blood vessels (kidney failure, diabetic retinopathy). 

Meanwhile, the majority of patients pay little attention to diabetes. According to the American Diabetes Association (ADA), the immune activity of diabetic patients is impaired, even when their blood sugar is well controlled, making them more susceptible to infections than other. Especially with those who have cardiovascular complications or kidney complications, the infection will worsen and the risk of death is higher.

The diabetic vaccination is considered as a necessary measure to reduce hospitalization rates and deaths . Side effects from vaccination are usually mild (such as pain, fever) and are very rare. 

FLU

Influenza is a global disease that usually occurs from October to April or May in the Northern Hemisphere, April to September in temperate climates in the southern hemisphere, and on year round in the heat region.

As recommended by the Advisory Committee on Immunization Practices (ACIP), vaccinating people at high risk before the flu season is the most effective way to reduce the harmful effects. Flu vaccination reduces the frequency of illness and reduces the cost of medical care.

According to ACIP, flu vaccine should be given to all diabetic patients ≥ 6 months old, vaccination time depends on regions in the world. In Vietnam, the injection time is at the beginning of September and should be repeated every year because the immunization of the vaccine decreases after 1 year.

PNEUMOCOCCAL INFECTIONS DISEASE

Diabetic patients are also susceptible to pneumococcal disease. Pneumococcal vaccine is not currently recommended for diabetics, except for the following special cases where a single booster is indicated: previously vaccinated patients over 65 years olds, patients under 65 have been vaccinated for more than 5 years, diabetic patients have associated chronic diseases such as nephrotic syndrome, chronic kidney disease, immunodeficiency status and post-transplant recipients.

INFLUENZA B

People with diabetes also have a higher rate of hepatitis B than other. The rate of non-elimination of hepatitis B virus after infection and progression to chronic hepatitis B is also higher. Poor glycemic control and immunodeficiency also increase B virus outbreaks, and increased risk of cirrhosis and liver cancer..

Hepatitis B prevention by vaccination with 3 doses of vaccine (first shot, second shot after 1 month and third shot after 5 months) can create protective immunity in 98% of patients. Hepatitis B vaccines produced using recombinant technology are safe and effective, side effects are rare.

In addition, according to the 2015 recommendation of the Centers for Disease Control and Prevention (CDC), diabetic patients should also receive additional vaccines DTaP or Tdap (to prevent 3 diseases: diphtheria, tetanus, pertussis) and chickenpox vaccine.

VACXIN DTaP OR TDAP

DTaP (Diphteria, Tetanus, acellular Pertussis) is a children's vaccine against diphtheria, tetanus and pertussis. Whooping cough is very dangerous if infected to young children. Children need to get 5 doses of DTaP vaccine before age 7 (at 2, 4, 6 months, 15-18 months and 4-6 years). A dose of immune booster for adolescents and adults is also recommended (usually recommended for children 11-12 years old) to maintain a strong immunity to whooping cough and prevent bacterial transmission from adults to young children.

Tdap (Tetanus, Diphteria, acellular Pertussis) is a vaccine against diphtheria, tetanus and pertussis, , intended for adults and adults. Often used for repeat injections in adults > 11-12 years old and adults. It is also recommended that pregnant women get one dose of Tdap per pregnancy (preferably between 27 and 36 weeks) to protect their babies from whooping cough.

CHICKEN POT

Chickenpox is a disease caused by the herpes virus group that easily develops chronic in immunocompromised sites and diabetic patients. Chronic viral infections are easy to reactivate and cause severe pain along the nerve, lasting effects to diabetic patients. Chickenpox in people with severe immunodeficiency can also lead to serious complications such as viral pneumonia, encephalitis, meningitis, superinfection of bacteria from the skin, sepsis. 

Diabetic patients who have never had chickenpox can be effectively prevented by injecting 2 separate doses in 4-8 weeks apart.

In summary, these infections cause unfavorable health conditions in diabetics, increase demand for drugs and medical care,hospitalization and mortality rates. Practicing adequate immunization for diabetic patients is the most active and effective measure to ensure quality of life, protect health, and significantly reduce morbidity and mortality rates for diabetic patients. Diabetic patients need to visit immunization clinics or endocrinology clinics for advice and avoid medical costs for any medical condition.