Concept of adult immunization and guidelines for vaccination in diabetes


Abdul Faheem Khan and F Diab

Sanofi India Ltd., India

: Endocrinol Diabetes Res

Abstract


Diabetes has emerged as a disease of major public health importance affecting the rich and the poor alike. Conventionally, comprehensive diabetes management is aimed at preventing micro and macro vascular complications. However, morbidity and mortality due to infections are also significant. In developing countries, the concept of adult immunization is far from reality. According to the World Health Organization (WHO), the mortality rate due to pneumococcal infections averages 10-20% while it may exceed 50% in high risk groups. It is estimated that people with diabetes are almost three times at higher risk of death due to pneumonia-related complications. Considering the economics of immunization in a developing country, providing free vaccines to all adults may not be a practical solution, although the free universal immunization program for children is in existence for several decades. There is no consensus on the use of vaccines in diabetes subjects in developing world. However, there are some clinics offering routine pneumococcal, influenza and other vaccinations. Patients with diabetes have a deranged immune system making them more prone for infections. Hospitalization and death due to pneumococcal disease and influenza are higher in diabetes patients. They, like other healthy individuals, have a normal humoral response to vaccination with clinically significant benefits. The American Diabetes Association, Advisory Committee on Immunization Practices, Centers for Disease Control and Prevention, World Health Organization, United Kingdom Guidelines and a number of other scientific organizations have well defined guidelines for vaccination in diabetes.

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