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Tuesday, September 02, 2014

Division of Diabetes Treatment and Prevention - Leading the effort to treat and prevent diabetes in American Indians and Alaska Natives


Standards of Care and Clinical Practice
Recommendations: Type 2 Diabetes

Last updated: July 2012

Immunizations

Clinical Practice Recommendations

Immunizations

recommendations icon Recommendations for Immunizations

Conduct an immunization status review at diabetes diagnosis and as a routine part of diabetes care.

Provide the following immunizations:

  • Annual influenza immunization.
  • Pneumococcal vaccine at diabetes diagnosis; re-immunization if ≥ 65 years, and first dose was given before age 65 and if vaccine was administered > 5 years prior.
  • Tetanus and diphtheria (Td) every 10 years; tetanus, diphtheria, and acellular pertussis (Tdap) should replace a single dose of Td for persons < 65 years who have not previously received a dose of Tdap.
  • Hepatitis B vaccination for unvaccinated adults with diabetes:
    • Adults < 60 years of age: recommended, as soon as feasible after diabetes diagnosis
    • Adults ≥ 60 years of age: consider, based on patient’s likelihood of acquiring hepatitis B virus infection (e.g., anticipated need for assisted blood-glucose monitoring), the likelihood of experiencing chronic sequelae or other complications if infected, and the decline in immunologic response to hepatitis B vaccine with advancing age.
  • Zoster vaccine for persons ≥ 60 years as a single dose, regardless of reported history of prior herpes zoster episode.
  • Human papillomavirus (HPV) vaccine:
    • Females ≤ 26 years of age
    • Males aged 11 to 12 years; a catch-up dose for males aged 13 to 21 years; and permissive use of the vaccine in males aged 22 to 26 years.

People with diabetes are at increased risk of contracting several vaccine-preventable infections and/or for experiencing more severe complications. Vaccinations are highly effective at reducing morbidity and mortality from these diseases.

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Resources

Tools for Clinicians and Educators

tools and resources icon Key Tools and Resources

Centers for Disease Control and Prevention. Recommendations and Guidelines:

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Patient Education Materials

Centers for Disease Control and Prevention.

Bibliography

Centers for Disease Control and Prevention. Recommended adult immunization schedule—United States, 2012. Exit Disclaimer: You Are Leaving www.ihs.gov Morb Mort Wkly Rep. 2012 Feb 3;61(4):1-7.

Centers for Disease Control and Prevention. Recommended immunization schedules for persons aged 0-18 years–United States, 2012. Exit Disclaimer: You Are Leaving www.ihs.gov Morb Mort Wkly Rep. 2012 Feb 10. Erratum in: Morb Mort Wkly Rep. 2012 Mar 2;61(08);147.

Kirkman MS, Schaffner W. Another shot to protect people with diabetes: add hepatitis B vaccination to the checklist; editorial. Exit Disclaimer: You Are Leaving www.ihs.gov [PDF]  Diabetes Care 2012 May;35:941-2. doi:10.2337/dc12-0164.

Division of Diabetes Treatment and Prevention | Phone: (505) 248-4182 | Fax: (505) 248-4188 | diabetesprogram@ihs.gov