Several research teams across the globe are working on a vaccine for diabetes. However, there’s still a long road ahead, as the research is still at a nascent stage. One can only hope for a breakthrough, allowing the vaccines to roll out sooner than later. Meanwhile, those battling diabetes can take appropriate precautions against other health complications by consulting their physician and taking the necessary vaccinations.
Dr Vinod Abichandani, diabetes and endocrine physician, Ahmedabad, says, “Diabetes affects the immune system in several ways, making individuals more susceptible to infections and impairing their ability to fight off pathogens effectively.” As a result, people with diabetes are at a higher risk of developing several other health conditions and hence, should be aware of the vaccines they can take to cut down the risks.
Vaccines and diabetes
Prof Atul Kalhan, consultant, diabetes & endocrinology, Royal Glamorgan Hospital, Wales, says, older people with sub-optimally controlled diabetes are more vulnerable to catching infections, and immunisation can help prevent them or reduce their severity. He adds, “Vaccines are recommended for everyone with diabetes, depending on their glycemic control, duration of the condition, infections prevalent in their local community and their overall health.”
He further explains that an otherwise fit 50-year-old individual newly diagnosed with diabetes may not require vaccines (other than for COVID). However, a 60-year-old person living with diabetes and other co-morbidities for several years should be encouraged to take the necessary vaccines.
Vaccines for people with diabetes
Experts list the following vaccines for people with diabetes to cut down the risk of severe health complications:
♦ COVID-19 vaccine
People with diabetes are more vulnerable to developing severe health complications if they get COVID. Hence, they are recommended to get vaccinated against the SARS-CoV-2 virus. The schedule for the COVID-19 vaccine and its booster doses can be planned as per the public health department.
♦ Influenza vaccine
Flu is a contagious respiratory illness caused by influenza viruses. Experts say it can be particularly severe for people with diabetes, leading to complications such as pneumonia, bronchitis, sinus infections, ear infections and worsening of glycemic control. Prof Dr Kalhan says the Centers for Disease Control and Prevention (CDC) recommends the flu vaccine annually for individuals with diabetes, which is usually administered in the fall before the flu season starts.
♦ Pneumococcal vaccines
People with diabetes are at an increased risk of developing pneumonia (lung infection), bacteremia (blood infection) and meningitis (infection in the lining of the brain and spinal cord), caused by the bacteria Streptococcus pneumoniae. Dr Abichandani says, “Two vaccines are available to combat the bacteria: the pneumococcal conjugate vaccine (PCV13) and the pneumococcal polysaccharide vaccine (PPSV23). While these vaccines are generally recommended for adults over 65 years of age, individuals with diabetes should receive them earlier, regardless of how old they are.”
♦ Hepatitis B vaccine
Hepatitis B is a viral infection that affects the liver, leading to chronic liver disease. It spreads through blood or other bodily fluids when blood sugar meters, finger stick devices or other diabetes care equipment (like insulin pens) are shared. Vaccination against hepatitis B is recommended for all individuals with diabetes who haven’t received the vaccine previously.
♦ Tdap vaccine
The Tdap vaccine provides protection against tetanus, diphtheria (severe infection of the throat and nose) and pertussis (whooping cough). Dr Abichandani says, “While tetanus and diphtheria are rare, pertussis cases have been increasing in recent years. Pertussis can be severe and persistent, leading to complications such as pneumonia.” Prof Dr Kalhan adds people with diabetes should take a one-time Tdap booster vaccine along with a Td (tetanus and diphtheria) booster vaccine once every 10 years.
♦ Zoster vaccine
This vaccine is administered for herpes zoster or shingles. Prof Dr Kalhan says, “Most of us were exposed to chickenpox as a child. It is the reactivation of the same virus in older adults.” Dr Abichandani explains that after an individual recovers from chickenpox, the virus stays in the body. “Years later, it may cause shingles (a viral infection that causes painful rashes). For some people, the pain can last for months or even years after the rash goes away — known as post-herpetic neuralgia (PHN),” he says. The vaccine is recommended by the CDC for people over 50.
♦ Other vaccines
Experts also recommend routine immunisations for people with diabetes. Vaccines like the varicella (chickenpox) vaccine and the measles, mumps and rubella (MMR) vaccine provide protection against viral infections that can have serious consequences.
Vaccination guidelines for people with diabetes
Prof Dr Kalhan emphasises that vaccination guidelines for people with diabetes should come from the local public health department or a microbiologist. “You cannot externally validate what is followed in the UK or US to your own population because the set of bacteria and viruses that lead to these infections is different. So, the guidelines need to come from the local public health department, as they would have the data on what infections are more common in a particular region,” he says.
Experts add that it’s important to note the impact of diabetes on the immune system. “Maintaining healthy blood sugar levels, exercising regularly, having a balanced diet and adhering to prescribed medications can help mitigate the effects of diabetes on the immune system. Additionally, individuals with diabetes should follow the recommended vaccination schedules and consult with healthcare professionals to address any specific concerns regarding their immune health,” says Dr Abichandani.
Takeaways
- Diabetes affects the immune system in several ways, making individuals more susceptible to infections.
- Vaccines that people with diabetes can take to reduce the risk of health complications include the COVID-19 vaccine, the zoster vaccine and the pneumococcal vaccines.
- Exercising regularly, having a balanced diet and adhering to prescribed medications can help mitigate the effects of diabetes on the immune system.
