Study backs giving flu vaccine to working-age adults with diabetes

All people with diabetes should receive influenza vaccination, according to guidelines in most high-income countries, but there has been little evidence to back this policy. However, a new study in Diabetologia (the journal of the European Association for the Study of Diabetes) suggests that working age adults with diabetes are at an increased risk of influenza compared with people without diabetes, affirming the need to target people with diabetes for influenza vaccination. The study is by the team led by Dr Jeffrey A. Johnson, School of Public Health, University of Alberta, Edmonton, AB, Canada.

The American Diabetes Association and the Canadian Diabetes Association, as well as national vaccination authorities in Canada and the UK, all recommend vaccinating people with diabetes against influenza. In the United States, influenza vaccinations are recommended for all , although priority continues to be placed on those with diabetes. Since separate recommendations already exist for vaccination in all elderly ( > 65 years) adults, the additional effect of guidelines calling for vaccinations in is to add working age (age ≥18 and <65 years) adults with diabetes as a high-risk group relative to those without diabetes.

The authors discuss how previous studies to assess the risk of influenza in adults with diabetes have had various methodological problems, so their aim was to do a new study to provide evidence on the recommendation to give the influenza vaccine to adults with diabetes.

The study used data from Manitoba, Canada, from 2000 to 2008. All working age adults with diabetes were identified and matched with up to two non-diabetic controls. The rates of physician visits and hospitalisations for influenza-like illness, hospitalisations for pneumonia and influenza, and all-cause hospitalisations were analysed. The study included 163,202 people, mean age 52.5 years, of whom just under half (48.5%) were women. The data showed that adults with diabetes had more co-morbidities and received influenza vaccination more often than those without diabetes. After adjusting for these differences, adults with diabetes had a 6% greater increase in all-cause hospitalisations associated with influenza compared to adults without diabetes. This translates to a total additional burden of 54 hospitalisations across Manitoba in working age adults due to their diabetes. No statistically significant differences were detected in influenza-attributable rates of the other outcomes, i.e.: influenza-like illness or pneumonia and influenza.

The authors say that the even if vaccination effectiveness were as low as 20%, it could be cost-effective to vaccinate adults with diabetes to avoid the costs of hospitalisation with influenza. However they add that the individual situation in different countries could vary depending on local practices and costs.

The authors say: "Our observation that working age adults with diabetes experience a greater burden of influenza than similar non-diabetic adults provides a clinical justification for targeted anti-influenza interventions; identifying particular interventions and evaluating their effectiveness in this population are questions for further research."

They conclude: "Vaccination guidelines indirectly single out working age adults with diabetes for routine vaccination. We have demonstrated an increased burden of influenza in this population. Randomised trials are needed to confirm actual vaccination effectiveness in this group. Formal economic studies are also required, to ascertain the extent to which identifying as a high-risk indication for vaccination may mitigate the use of healthcare resources and costs associated with influenza. Until such studies are available, our work represents the strongest current evidence highlighting the burden of , and the potential benefits of , in diabetic adults."

add to favorites email to friend print save as pdf

Related Stories

CDC says more people with asthma getting flu shots

Dec 06, 2013

(HealthDay)—Influenza vaccination has increased substantially among people with asthma since the Advisory Committee on Immunization Practices (ACIP) expanded recommendations for annual vaccinations, though ...

Recommended for you

Screening for diabetes at dental visits using oral blood

Feb 26, 2015

It is estimated that 8.1 million of the 29.1 million Americans living with diabetes are undiagnosed and many who have diabetes have poor glycemic control. Given that each year many Americans visit a dental provider but not ...

CBT, sertraline insufficient in diabetes and depression

Feb 26, 2015

(HealthDay)—For patients with diabetes and depression, improvements in depression are seen with cognitive behavioral therapy (CBT) or sertraline, with a significant advantage for sertraline, but glycemic ...

Early signs in young children predict type 1 diabetes

Feb 26, 2015

New research shows that it is possible to predict the development of type 1 diabetes. By measuring the presence of autoantibodies in the blood, it is possible to detect whether the immune system has begun to break down the ...

Daily menu plan reduces blood sugar significantly

Feb 25, 2015

A large group of people with diabetes who followed a menu plan created by University of Alberta nutrition researchers for just three months significantly reduced their blood sugar levels.

User comments

Adjust slider to filter visible comments by rank

Display comments: newest first

nik_kelly_54
not rated yet Jan 24, 2014
IMHO, unless you have genuine medical reason to NOT get Seasonal 'Flu or Decadal Pneumonia vaccinations, have both and stack the odds in your favour.

Downside is you'll end up shopping for a bunch of neighbours and visiting kin who didn't bother...

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.