What Side Effects Of The Vaccine Should People With Diabetes Pay Attention To
In general, the most common side effects of both vaccines are pain, swelling, and redness at the injection site. Other common side effects are chills, tiredness, and headaches. Most of these side effects are mild, but some people had more severe reactions that interfered with daily activities.
Both the Moderna and Pfizer vaccines carry a warning label for increased risk for inflammation of the heart called myocarditis. In an analysis published in September 2021 in NEJM researchers reported the Pfizer vaccine had a rare, but increased risk for myocarditis. This is more common in young men, according to two studies published in October 6, 2021, in NEJM. However, infection with COVID-19 carries an even greater risk of myocarditis.
Gabbay says side effects of the COVID-19 vaccines are similar to those of flu vaccines. For someone living with diabetes, keeping a sick-day kit with extra medications and supplies is beneficial in case you do not feel well after inoculation.
Learn more about the rollout of COVID-19 vaccines for people with type 1 and type 2 in Diabetes Daily’s article COVID-19 Vaccine for People With Diabetes: What’s Going On?
Herpes Zoster And Diabetes
Evidence from previous studies has demonstrated that diabetes mellitus is often accompanied by impaired cell-mediated immunity . Individuals with diabetes are more prone to infection than individuals without diabetes . The clinical evidence regarding diabetes as a risk factor for herpes zoster is scarce. A study conducted by Okamoto et al showed an association between diabetes and herpes zoster . Among individuals with diabetes between the ages of 41 to 79 years of age, there was significantly lower cell-mediated immunity to varicella zoster virus compared to the individuals without diabetes .
According to the Advisory Committee on Immunization Practices and Canadian Public Health Services , recommendations for the herpes zoster vaccine are as follows:
- Routinely recommend for adults 60 years of age.
- Vaccination before 60 years of age might not have the required protection when the risks and complications of herpes zoster are highest .
- Protection offered by the herpes zoster vaccine wanes within the first 5 years .
- Beyond 5 years of vaccination, duration of protection is uncertain.
- Immunocompromised individuals are an important group to consider when discussing vaccinations, such as herpes zoster vaccine.
How Do I Tell Whether I Have The Flu Or A Common Cold
Both the flu and the common cold result from viruses, but the flu is a deadly killer that packs a major punch. Its like the difference between a tropical depression and a Category 5 hurricane. Official flu symptoms include fever, cough, sore throat, runny or stuffy nose, body aches, headache, chills and fatigue, sometimes sprinkled with vomiting and diarrhea. The body aches tend to be a key warning sign for most people that they have the flu, rather than a cold.
Remember that any cold or illness striking someone with diabetes can cause our blood sugars to spike. The result can be dangerous diabetic ketoacidosis , so testing for ketones is important. This can be done using an at-home urine testing kit widely available at drug stores without a prescription.
Also please remember that for those without diabetes, flu-like symptoms frequently appear as a telltale sign of newly-onset diabetes and it can get deadly, very quickly. So make sure to know the warning signs of diabetes and be ready to handle this whether its actually the flu or not.
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Persons With Chronic Diseases
Refer to Immunization of Persons with Chronic Diseases in Part 3 for additional information about vaccination of people with chronic diseases.
Asplenia or hyposplenia
Hyposplenic or asplenic individuals should receive Pneu-C-13 vaccine and Pneu-P-23 vaccine, followed by a booster dose of Pneu-P-23 vaccine. Refer to Table 3, Table 4 and Booster doses and re-immunization for additional information.
Chronic kidney disease and patients on dialysis
Individuals with chronic kidney disease should receive age appropriate pneumococcal vaccines. Children less than 18 years of age with chronic kidney failure or nephrotic syndrome, should receive Pneu-C-13 vaccine and Pneu-P-23 vaccine. Adults with chronic kidney failure should receive Pneu-P-23 vaccine. Adults with nephrotic syndrome should receive Pneu-C-13 and Pneu-P-23 vaccine. Due to the decreased immunogenicity and efficacy of Pneu-P-23 vaccine in children and adults with chronic kidney failure, 1 booster dose of Pneu-P-23 vaccine is recommended. Refer to Table 3, Table 4 and Booster doses and re-immunization for additional information.
Chronic lung disease, including asthma
Chronic heart disease
Chronic liver disease
Endocrine and metabolic diseases
Non-malignant hematologic disorders
Tdap For Tetanus Diphtheria And Pertussis
Lastly, there is the shot to protect against tetanus , diphtheria , and pertussis . The shot both protects adult and prevents disease transmission to younger children.
Taking these steps to get vaccinated can help prevent the complications of having diabetes. It may seem like a lot of shots, but only the flu shot is needed every year and the others work longer-term.
These vaccinations are available at your primary care doctors office as well as at pharmacies. Not every primary care physician is aware of the current vaccination needs of people with diabetes, and it can be hard for your diabetes doc to cover all of your diabetes concerns in a normal visit. So, be sure to keep a vaccination record and ask for your recommended vaccinations. For more information visit:
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Should You Get A Flu Shot
In general, every person with diabetes needs a flu shot each year. Talk with your doctor about having a flu shot. Flu shots do not give 100% protection, but they do make it less likely for you to catch the flu for about six months.
For extra safety, it’s a good idea for the people you live with or spend a lot of time with to get a flu shot, too. You are less likely to get the flu if the people around you don’t have it.
The best time to get your flu shot is beginning in September. The shot takes about two weeks to take effect.
If youre sick , ask if you should wait until you are healthy again before having your flu shot. And don’t get a flu shot if you are allergic to eggs.
You are advised to continue to take the general precautions of preventing seasonal flu and other communicable illnesses and diseases:
- Cover your nose and mouth with a tissue when you cough or sneeze. Throw the tissue in the trash. If you dont have a tissue, cough or sneeze into your elbow, not your hand.
- Wash your hands often with soap and water, especially after you cough or sneeze. Alcohol-based hand cleaners are also effective.
- Avoid touching your eyes, nose, or mouth. Germs spread that way.
- Try to avoid close contact with sick people.
- If you get sick, stay home from work or school and limit contact with others to keep from infecting them.
Vaccinations You Need If You Have Diabetes
People with diabetes face a higher risk for many vaccine-preventable illnesses. Here’s what you should know to keep up with your shots.
Staying healthy with diabetes is about more than just controlling your blood sugar. Keeping up-to-date on vaccinations, like flu shots, is also an important part of diabetes management.
People with diabetes typically dont handle infections as well, says William Schaffner, MD, an infectious disease specialist and professor of preventive medicine at Vanderbilt University in Nashville, Tennessee.
Diabetes can cause an altered immune response that increases the susceptibility to and severity of infections, such as the flu, Dr. Schaffner says. We also know that blood sugar levels can be negatively affected when a person with diabetes is under physiologic stress like infection, he adds.
In addition, “people with diabetes are at higher risk of complications from many vaccine-preventable illnesses, so why not focus on prevention? asks Deborah Malkoff-Cohen, RD, a dietitian and certified diabetes educator in private practice in New York City.
Your Vaccination To-Do List
The three most important vaccines for people with diabetes are:
Flu: If you have diabetes, you should be at the head of the line when the annual flu shot becomes available, says Schaffner. People with all forms of diabetes are more likely to become infected and are more susceptible to complications of flu, he says.
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The Best Flu Treatment Is Prevention
Getting a flu shot is the single intervention that can keep you healthier during flu season, Dr. Hamaty says. We dont recommend the nasal spray vaccine for people with diabetes.
Along with the vaccination, protect yourself with common sense precautions. While its impossible to be in a completely sterile environment, its crucial to follow these simple steps to stay healthy, especially in the age of COVID-19:
- Wash your hands with soap and water, especially after coughing or sneezing.
- Dont touch your eyes, nose and mouth, which can spread germs.
- Avoid close contact with anyone you know who is sick.
- Cover your mouth and nose with a tissue if youre coughing or sneezing, and throw the tissue out after you use it.
One good thing about COVID-19: Social distancing practiced for the prevention of COVID-19 will help reducing the spread of flu.
The Hepatitis B Vaccine
Hepatitis B, or hep B, is commonly transmitted by blood, which means people with diabetes who use needles for insulin are at a higher risk of being infected. Vaccination can prevent the potential liver disease and liver cancer that can result from contracting hep B. Vaccination for hep B is recommended for people with diabetes who are under the age of 60.
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Why Inadequately Controlled Diabetes Heightens Risk
The immune system of people with uncontrolled or less controlled diabetes is weakened. For this reason, they are more likely to develop complications of flu even potentially life-threatening conditions, such as bacterial pneumonia.
The risk of pneumonia in people with diabetes is even greater if they have other chronic conditions, including chronic kidney disease and chronic obstructive pulmonary disease .
Flu and infections can worsen blood glucose control and exacerbate diabetes symptoms, particularly in people whose diabetes is less controlled. This can lead to more serious conditions.
Glucose control can become even more difficult to treat if you need treatment with steroids for managing pneumonia, bronchitis and/or COPD.
Those with uncontrolled diabetes can also develop severely high blood sugars, which can lead to a hyperglycemic state or diabetic ketoacidosis, both of which require hospitalization.
Other problems may occur even after the flu is gone. Worsening glucose control might last longer than your bout of the flu, Dr. Hamaty says. So even after managing high glucose levels during your illness, you may need to readjust your diabetes regimen. When you add new and sometimes costly diabetes medications to manage blood sugars, you may develop new side effects as well, he says.
Diabetes And The Flu Shot: What To Know
Whenever a nip of cold is in the air, and coughs and sneezes ring out in public places, you know its flu season again. If you live with diabetes, youre probably being prodded to go get a flu shot and related vaccines.
But over the years, our mailbag has filled up with questions about how those shots may mix with diabetes care.
Heres a Q& A covering all you need to know:
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What Vaccines Are Available
In November 2020, Pfizer and BioNTech announced positive results from the conclusion of their COVID-19 vaccine clinical trials, quickly followed by Moderna. In February 2021, Johnson & Johnsons announced the same.
Each has now been approved for use in multiple countries across the globe, with a few other vaccines rolling out on a country-by-country basis. Worldwide, more than 90 other vaccines are in various stages of clinical trials.
Each vaccine went through the standard three phases of clinical trials Phase 1, where it is administered to a small number of people to show initial safety, Phase 2 to hundreds of people split into groups by things like age, ethnicity, and background to show how different types of people react to the vaccine, then Phase 3, in which it is given to tens of thousands of people, tested against a placebo. Because of the speed needed for development, both vaccines were approved to go through animal clinical trials at the same time as human Phase 1 clinical trials.
The Pfizer/BioNTech and Moderna vaccines are mRNA vaccines, a type of immunization that does not use the real virus in the vaccine, but instead employs a piece of genetic material to create antibodies against the novel coronavirus. Each of the mRNA vaccines requires two doses, given three to four weeks apart. The Johnson & Johnson vaccine is slightly different, which makes it easier to store and only requires one dose.
Do Covid Vaccines And Diabetes Mix Well
People with diabetes in each of the vaccine trials have not reported major side effects. Overall, some clinical trial participants have reported mild side effects of the vaccines, much like how some people experience injection-site soreness, mild lethargy, a low-grade fever after other vaccines. These mild reactions some people experience after vaccines are typical and not cause for alarm they are a result of the immune system going into action as purposely triggered by the vaccine, creating the ability to fight against the actual virus were a person to be exposed to it.
In the UK, two healthcare workers who received the Pfizer/BioNTech vaccine during the initial general population rollout experienced severe allergic reactions for which they administered adrenaline autoinjectors. Both individuals had a history of severe anaphylactoid reactions for which they carry adrenaline autoinjectors anyway, so if you are a person who does tend to experience severe allergic reactions, it is recommended that you not receive the Pfizer/BioNTech vaccine at this time. Other vaccines may be better indicated for your use. If you do not have a history of severe allergic reactions, there is no reason to expect you will experience one from a vaccine.
If you have specific concerns or worries, make sure you speak to a healthcare provider you trust.
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Who Should Not Get The Pneumonia Vaccine
Again, its best to determine this with your doctor, but as a general rule, the CDC states you should not get the pneumococcal vaccine if:
- You or your child has had a severe or life-threatening allergy to the current PCV13 or Prevnar 13®) vaccine, the past PCV7 vaccine or any vaccine containing diphtheria toxoid.
- You or your child are currently battling a severe illness.
Influenza Vaccination In Adults
Data regarding influenza morbidity and mortality in people with diabetes are based on retrospective analyses during influenza epidemics . A recent epidemiological analysis of pandemic influenza demonstrated that people with diabetes are more likely to be hospitalized or to require intensive care . One study demonstrated that, in a Canadian cohort of working-age adults, individuals with diabetes had an increased rate of hospitalizations from influenza-like and pneumonia-influenza illness, as well as all-cause hospitalizations . Over a period of 10 influenza seasons, influenza vaccination was shown to be effective in reducing both death and hospitalization from influenza and pneumonia in a cohort that included people with diabetes . Two large cohort studies have found that influenza vaccination decreased hospitalizations in both the elderly and working-age adults .
A Dutch case-control study documented that the incidence of complications was 2 times higher in the unvaccinated group compared to the vaccinated group . The rates of hospitalization for influenza, pneumonia, other acute respiratory diseases, myocardial infarction, congestive heart failure, and stroke or diabetes events were reduced by 70%.
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Are People With Diabetes Eligible For A Covid
People with diabetes are at higher risk for complications from COVID and therefore are priority individuals for a vaccine booster based on FDA approval, says Dr. Gabbay. As of October 20, a COVID-19 vaccine booster shot is available for people who received the Pfizer-BioNTech vaccine or the Moderna vaccine at least six months ago, according to the FDA. People who got the Johnson & Johnson vaccine are also eligible to receive that vaccines booster at least two months after receiving the single dose. People who received one type of vaccine may receive a different type of booster that is, people may mix and match vaccines, the FDA says.
The CDC says these groups should get a booster:
- Seniors ages 65 and older
- People ages 18 or older who live in long-term care settings
The CDC says these groups may get a booster:
- People ages 18 and older with underlying medical conditions, including type 1 or type 2 diabetes, based on their individual benefits and risks
- People ages 18 or older who live or work in high-risk settings such as homeless shelters, grocery stores, healthcare facilities, or schools
- Additional people, depending on doctors evaluation of their benefits and risks
After the CDCs recommendations, each individual state rolls out its booster program.
Boosters are important because studies have shown that vaccine protection against SARS-2 coronavirus can decrease over time and be less protective against the delta variant, according to the CDC website.
Who Should Get The Vaccine
People over age 65. As you age, your immune system doesnât work as well as it once did. Youâre more likely to have trouble fighting off a pneumonia infection. All adults over age 65 should get the vaccine.
Those with weakened immune systems. Many diseases can cause your immune system to weaken, so itâs less able to fight off bugs like pneumonia.
If you have heart disease, diabetes, emphysema, asthma, or COPD , youâre more likely to have a weakened immune system, which makes you more likely to get pneumonia.
The same goes for people who receive chemotherapy, people who have had organ transplants, and people with HIV or AIDS.
People who smoke. If youâve smoked for a long time, you could have damage to the small hairs that line the insides of your lungs and help filter out germs. When theyâre damaged, they arenât as good at stopping those bad germs.
Heavy drinkers. If you drink too much alcohol, you may have a weakened immune system. Your white blood cells donât work as well as they do for people with a healthy immune system.
People getting over surgery or a severe illness. If you were in the hospital ICU and needed help breathing with a ventilator, youâre at risk of getting pneumonia. The same is true if youâve just had major surgery or if youâre healing from a serious injury. When your immune system is weak because of illness or injury or because itâs helping you get better from surgery, you canât fight off germs as well as you normally can.
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