Are any vaccines contraindicated in patients with Diabetes Mellitus (DM)?

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Last updated: April 25, 2025View editorial policy

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From the Guidelines

There are no vaccines specifically contraindicated for people with diabetes, and individuals with diabetes are generally encouraged to stay up-to-date with all recommended vaccinations. In fact, people with diabetes may be at higher risk for complications from certain infectious diseases, making vaccination particularly important. Annual influenza vaccination is crucial for diabetic patients, as is the pneumococcal vaccine series. The COVID-19 vaccines are also recommended for people with diabetes. Some vaccines, particularly live attenuated vaccines like the intranasal flu vaccine (FluMist), might require additional consideration in people with poorly controlled diabetes or those with significant complications, but this is assessed on an individual basis 1.

The standard inactivated vaccines, including those for hepatitis B, tetanus, diphtheria, pertussis, and others, are safe for diabetic patients. Vaccination administration follows standard dosing and scheduling guidelines regardless of diabetes status. People with diabetes should inform their healthcare provider about their condition when receiving vaccines, but diabetes itself does not limit vaccine options. According to the most recent guidelines, individuals with diabetes should receive routine vaccinations as for the general population, with particular emphasis on annual influenza vaccination and pneumococcal polysaccharide vaccine 1.

Key considerations for vaccine administration in people with diabetes include:

  • Annual influenza vaccination is recommended for all individuals ≥6 months of age who do not have a contraindication 1.
  • Pneumococcal polysaccharide vaccine is recommended for all patients with diabetes ≥2 years of age 1.
  • Hepatitis B vaccination is recommended for unvaccinated adults with diabetes who are aged 19–59 years, and consideration should be given to vaccinating those aged ≥60 years 1.
  • Live attenuated vaccines, such as the intranasal flu vaccine, may require additional consideration in people with poorly controlled diabetes or significant complications 1.

Overall, the benefits of vaccination in people with diabetes outweigh the risks, and individuals with diabetes should be encouraged to stay up-to-date with all recommended vaccinations.

From the Research

Vaccine Contraindications for Diabetes

  • There are no specific vaccines contraindicated for diabetes, but live attenuated vaccines should be carefully considered in patients with unstable glycaemia and significantly impaired immune system due to diabetes mellitus 2.
  • Inactivated vaccines are safe to use in diabetic patients, even in those who are immunocompromised, as long as general contraindications are respected 3.
  • The decision to vaccinate a diabetic patient with a live attenuated vaccine should be weighed against the risks of exposure to the specific infectious agent 2.
  • Diabetic patients can benefit from vaccination, which may have life-saving potential, and there is no reason to be afraid of vaccination in this population as long as general contraindications are respected 2.

Recommended Vaccines for Diabetic Patients

  • Inactivated vaccines are preferred for diabetic patients due to their safety profile, even in immunocompromised individuals 3.
  • Vaccines against tick-borne encephalitis (TBE), viral hepatitis, invasive pneumococcal and meningococcal infections can be administered to diabetic patients, with careful consideration of individual patient factors 2.

Non-Relevant Studies

  • A study on projections to the visual cortex in the golden hamster is not relevant to vaccine contraindications for diabetes 4.

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Vaccination of patients with diabetes mellitus--a retrospective study.

Central European journal of public health, 2011

Research

[Vaccines recommended for diabetic patients].

Vnitrni lekarstvi, 2020

Research

Projections to the visual cortex in the golden hamster.

The Journal of comparative neurology, 1979

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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