World Immunisation Week, celebrated in the last week of April, aims to highlight the collective action needed to promote the use of vaccines to protect people of all ages against disease. The goal of World Immunisation Week is for more people, and their communities, to be protected from vaccine-preventable diseases. 

Immunisation is highly effective in reducing morbidity and mortality caused by vaccine-preventable diseases. Childhood vaccination for diphtheria was introduced in Australia in 1932 and use of vaccines to prevent tetanus, pertussis (whooping cough) and poliomyelitis became widespread in the 1950s.  This was followed by vaccines for measles, mumps and rubella in the 1960s and in more recent years, vaccines have been introduced for hepatitis B, pneumococcal disease, influenza and COVID-19.   

This article aims to summarise the importance of vaccines for protecting against disease for people living with diabetes. 

Influenza 

Everyone living with diabetes should be highly encouraged to get the annual influenza (flu) vaccine to reduce their risk of getting the flu. People living with diabetes, even when their diabetes is well-managed (blood glucose levels are largely sitting in the safe target ranges), are at high risk of serious flu complications. The flu can make chronic health problems, such as diabetes, worse. This is because diabetes may make the immune system less able to fight infections. In addition, illness can make it harder to manage blood glucose levels, leaving blood glucose levels to climb. 

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. 

Annual vaccination should ideally occur before the onset of each flu season, which usually occurs from June to September in most parts of Australia. The flu vaccination program will commence in April, providing protection before the peak of the expected season. If you do get sick over winter it is important to follow sick day guidance. 

COVID-19 and diabetes 

COVID-19 is a respiratory illness caused by a new virus SARS-CoV-2. Symptoms can include fatigue, fever, coughing, sore throat and shortness of breath. The virus can spread from person to person, but good hygiene can help to prevent infection. The COVID-19 vaccinations are safe and have been approved by the Therapeutic Goods Administration’s (TGA) rigorous testing process. All vaccines currently approved by the TGA (AstraZeneca, Pfizer, Moderna and Novavax) are suitable for use in adults living with diabetes. 

It is important that as many Australians as possible get vaccinated. This is the best path forward in the fight against the Covid-19 virus. 

Recommended vaccinations for people living with type 2 diabetes

The Royal Australian College of General Practitioners (RACGP) general practice management of type 2 diabetes recommends the following vaccinations for people living with type 2 diabetes: 

• Influenza – annual vaccination is recommended for people with chronic conditions, including diabetes, that require regular medical follow-up or have required hospitalisation in the past year 
• Diphtheria, tetanus, pertussis – for all adults aged 65 years and over if they have not had one in the previous 10 years 
• Hepatitis B – consider for travellers to hepatitis B-endemic areas 
• Herpes zoster – consider for ages 70–79 years (available for free in this age group under the National Immunisation Program)  
• Pneumococcus – diabetes is considered a ‘Category B’ condition for increased risk of invasive pneumococcal disease. It is recommended that all adults with type 2 diabetes receive three lifetime doses of the 23-valent pneumococcal polysaccharide vaccine (23vPPV), as follows: 
  • first dose at around age 18 years, or at time of diagnosis of type 2 diabetes  
  • second dose 5 – 10 years later  
  • third dose at least five years later or at age 65 years, whichever is later