Vaccinations for people with diabetes
Written by Carolien Koreneff, CDE-RN, FADEA
Each year, thousands of people in Australia become unwell with vaccine preventable illnesses. Particularly at this time of year, when the days shorten, and the weather gets colder.
While people living with diabetes are not necessarily at higher risk of influenza, COVID-19 and pneumonia, they could be at higher risk of complications associated with these infections.
Vaccinations are a great defence against viral infections such as COVID-19, influenza (“the flu”) and pneumococcal infection.
Vaccinations don’t provide complete protection. People can still get the infection even if they have had the vaccine, however symptoms should be milder, and the risk of hospitalisation and complications are generally lower.
Vaccinations can also slow the spread of viral infections in the community and thereby reduce the burden on hospitals.
COVID-19, Influenza and pneumococcal vaccinations need to be updated regularly as viruses change over time.
Why viral infections pose increased risks for people with diabetes.
Viral infections are more serious for people living with diabetes, as they are more likely to be hospitalised and more likely to die from the complications.
One of the reasons why viral infections can make a person with diabetes more unwell, is because glucose levels can increase in response to the increased levels of stress hormones associated with the infection.
Additionally, diabetes can impair the immune system and this can affect the body’s ability to fight off the virus, increasing the risk of hospitalisation.
Also, when a person is unwell it is usually harder for them to eat and drink and to take medications regularly as prescribed, and this can lead to fluctuating glucose levels.
Fluctuations in glucose levels tend to drag out the effects of the infection and increase the risk of associated complications.
It is therefore recommended that all people with diabetes (and other chronic conditions) get the annual flu vaccine and regular COVID-19 booster vaccines.
Influenza is a highly contagious viral infection of the respiratory tract. It affects people of all ages, can cause severe illness and life-threatening complications. The best protection against “the flu” is yearly vaccination.
While protection is generally expected to last throughout the year, the highest level of protection occurs in the first three to four months after vaccination. As the peak period of influenza circulation is typically June to September in most parts of Australia, vaccination from mid-April onwards will almost certainly result in peak immunity during the influenza season. However, it’s never too late to vaccinate, as influenza can spread all year round.
A vaccinated person is 40-60% less likely to experience “the flu” or, if they do become infected, are more likely to experience milder symptoms.
The only contraindications to influenza vaccines are:
- Anaphylaxis following a previous dose of any influenza vaccine
- Anaphylaxis following any vaccine component (excluding eggs).
The annual influenza vaccine is recommended for everyone aged six months and older. It is free under the National Immunisation Program (NIP) for children aged six months to five years and adults 65 years and over, as well as pregnant women, Aboriginal and Torres Strait Islander people, and people with certain medical conditions, such as diabetes.
COVID-19 is the disease caused by the coronavirus, SARS-CoV-2. In some people it causes mild symptoms, but in others it can cause severe illness and death.
At first there were fears that people with diabetes may be at greater risk of contracting COVID-19, but this does not seem to be the case. However, having diabetes and hyperglycaemia (high glucose levels) are risk factors for a more severe COVID-19 infection.
The best way to protect against COVID-19 infection is to get vaccinated. All vaccines currently approved by the TGA (AstraZeneca, Pfizer, Moderna and Novavax) are suitable for use in adults living with diabetes.
The current recommendations for receiving a 2023 COVID-19 vaccine booster are:
- Aged over 65yrs and last COVID-19 vaccine dose or confirmed infection was over 6 months ago
- Over 18years with a health condition that may contribute to increased risk of severe COVID-19 disease, such as diabetes
It is also recommended for:
- Those aged 18 to 64 years, without increased risk of severe COVID-19 disease if their last vaccine or confirmed infection was at least 6 months ago
- Children aged 5 and 17 years with a health condition that contributes to increased risk of severe COVID-19 disease, such as diabetes
The flu and COVID-19
It is possible for people to have COVID-19 and the flu at the same time, as both viruses are spread in similar ways.
Contrary to popular belief, if a person had COVID-19, it doesn’t mean they have immunity to the flu. And if they had a COVID-19 vaccine, it will protect against COVID-19 only. This is why it’s important to protect against both viruses by getting the annual flu shot and the COVID-19 vaccination and boosters.
Australian Technical Advisory Group on Immunisation advises that influenza vaccines can now be co-administered (i.e. on the same day) with the COVID-19 vaccines.
Reducing risk factors
In addition to being vaccinated it is recommended that people with diabetes aim to keep their glucose levels in their target range as much as possible. High glucose levels impair the body’s immune reaction to viruses and increase the likelihood of secondary bacterial infections, potentially delaying recovery.
Practising good hand hygiene, wearing a face mask in public and social distancing during peak seasons are additional precautions that can help reduce the risk of viral infections.
For more information you may like to read Recommended vaccinations for those living with type 2 diabetes.