From the Guidelines
For a 62-year-old male diabetic, vaccination recommendations include annual influenza vaccination with a dose of 0.5 mL of a quadrivalent inactivated influenza vaccine, such as Fluzone or Fluad.
Pneumococcal Vaccination
Additionally, a single dose of pneumococcal conjugate vaccine (PCV20) is recommended, or a single dose of PCV15 followed by a dose of pneumococcal polysaccharide vaccine (PPSV23) at least 1 year later 1.
- The patient's diabetes mellitus is considered an underlying medical condition that increases the risk of pneumococcal disease, making pneumococcal vaccination a crucial preventive measure.
- The recommended pneumococcal vaccination schedule for adults with chronic medical conditions, such as diabetes, is outlined in the Advisory Committee on Immunization Practices (ACIP) guidelines 1.
Herpes Zoster Vaccination
Furthermore, vaccination against herpes zoster with a 2-dose series of Shingrix, administered 2-6 months apart, is also recommended for individuals aged 50 years and older, including those with diabetes.
- The Centers for Disease Control and Prevention (CDC) recommends herpes zoster vaccination for adults aged 50 years and older, regardless of their medical history 1.
- The patient's age and diabetes status make him eligible for herpes zoster vaccination, which can help prevent herpes zoster and its complications, such as postherpetic neuralgia.
Hepatitis B Vaccination
It is also recommended that adults with diabetes receive hepatitis B vaccination, as soon as possible after diabetes is diagnosed, especially if they are younger than 60 years 1.
- The ACIP recommends hepatitis B vaccination for adults with diabetes, as they are at increased risk of hepatitis B infection due to potential exposures during medical interventions, such as blood glucose monitoring.
- However, the decision to vaccinate against hepatitis B should be made on a case-by-case basis, considering the patient's individual risk factors and medical history.
Overall, the vaccination recommendations for a 62-year-old male diabetic include annual influenza vaccination, pneumococcal vaccination with PCV20 or PCV15 followed by PPSV23, herpes zoster vaccination with Shingrix, and consideration of hepatitis B vaccination based on individual risk factors 1.
From the Research
Vaccination Recommendations
The vaccination recommendations for a 62-year-old male with diabetes mellitus (DM) include:
- Influenza vaccination: The adjuvanted inactivated influenza vaccine quadrivalent (aIIV4) is recommended for adults 65 years of age and older, but studies have also shown its effectiveness in adults 50-64 years of age, especially those with comorbidities 2, 3.
- Pneumococcal vaccination: Routine pneumococcal vaccination is recommended for adults aged ≥60 or ≥65 years and those with underlying at-risk and high-risk conditions, such as diabetes mellitus 4.
Considerations for Older Adults with Diabetes
When considering vaccination recommendations for older adults with diabetes, it is essential to take into account their overall health status and comorbidities. Studies have shown that older adults with diabetes are at a higher risk of hospitalization and mortality, especially if their glycemic control is poor 5. Additionally, older adults with diabetes may have impaired immune responses to vaccines, making it crucial to choose the most effective vaccine options 3.
Vaccine Effectiveness and Safety
The effectiveness and safety of vaccines in older adults with diabetes have been studied, and the results show that:
- The aIIV4 is effective in preventing influenza and its complications in older adults, with a more pronounced immune response in those with medical comorbidities 3.
- The 23-valent pneumococcal polysaccharide vaccine (PPSV23) is effective against vaccine-type invasive pneumococcal disease and vaccine-type pneumococcal pneumonia, but its effectiveness may be lower in adults aged ≥75 years or those with certain underlying conditions 4.
- The safety profiles of these vaccines are generally well-tolerated, with common adverse reactions including injection site pain, fatigue, headache, arthralgia, and myalgia 2, 3.