Update on Immunizations for Adults with Diabetes

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Update on Immunizations for Adults with Diabetes

Transcript Of Update on Immunizations for Adults with Diabetes

Update

on Immunizations for Adults with Diabetes
Jillian Doss-Walker, MPH
Interim IHS Immunization Program Mgr./ CDC Public Health Advisor Indian Health Service, Immunization Program (Federal Assignee) Centers for Disease Control and Prevention (CDC) Advancements in Diabetes Webinar September 15, 2020

Disclaimer
The findings and opinions expressed in this presentation are those of the author and do not necessarily reflect the view of the Indian Health Service (IHS) or the Centers for Disease Control and Prevention (CDC).
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Overview
• Background • Immunization Recommendations
• Adults • Persons with Diabetes • Adolescents • Current Immunization Coverage • Improving immunization coverage • RPMS/EHR reporting and tools • Strategies and Best Practices • Resources
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Why Do People with Diabetes Need Immunizations?
• People with diabetes may have a harder time fighting off infections due to weaker immune systems and could be at increased risk for more serious complications from an illness compared to people without diabetes • Influenza can raise blood glucose levels to very high levels • Higher rates of hepatitis B among people with diabetes than compared to people without diabetes • Increased risk for illness or death from pneumonia
• Immunization provides the best protection against vaccinepreventable diseases
• Vaccines are one of the safest ways for people with diabetes to protect their health
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Table 1: Recommended Adult Immunization by Age Group, United States, 2020
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Advisory Committee on Immunization Practices (ACIP) Routine Adult Immunization Recommendations

• Td
• Booster every 10 years
• Tdap
• 1 dose, regardless of interval with Td
• Human Papillomavirus Vaccine (HPV)
• 19–26 years (Females and Males) • 27–45 (depending on shared clinician and
patient decision-making)
• Zoster
• 50 years+

• Influenza
• Annually
• Meningococcal B (Men B)
• 19-23 years (depending on shared clinician and patient decision-making)
• Pneumococcal
• Polysaccharide, 23-valent (PPSV23, a.k.a. Pneumovax®) 65 years
• PCV13 (65 years+, depending on shared clinician and patient decision-making)
• May start earlier for certain high-risk populations – e.g., AI/AN in certain geographic regions)
Adult Vaccine Schedule: https://www.cdc.gov/vaccines/schedules/hcp/imz/ adult.html

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Immunizations for Those with Diabetes
• Pneumococcal • Influenza • Hepatitis B • Zoster • Tdap
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Table 2: Recommended Adult Immunization Schedule by Medical Condition and Other Indications, United States, 2020
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Pneumonia and Influenza
• American Indian and Alaska Native people are almost two times more likely to die from pneumonia and influenza than non-Hispanic whites1,2 • Significant variation by region and age group
• During the 2009 H1N1 influenza pandemic, AI/AN people were four times more likely to die from influenza-related complications than other racial groups2
• Reasons for this disparity include a higher rate of chronic medical conditions, including DIABETES
• Source 1. Pneumonia and Influenza Mortality Among American Indian and Alaska Native People, 1990–2009.
• https://pubmed.ncbi.nlm.nih.gov/24754620/
• Source 2. Trends in Pneumonia and Influenza Morbidity and Mortality. American Lung Association.
• https://www.lung.org/getmedia/98f088b5-3fd7-4c43-a490-ba8f4747bd4d/pi-trend-report.pdf.pdf
• Source 3. Deaths Related to 2009 Pandemic Influenza A (H1N1) Among American Indian/Alaska Natives – 12 States, 2009
• http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5848a1.htm
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Pneumococcal
• Two vaccines help protect against pneumococcal disease:
• Pneumococcal conjugate vaccine (PCV13)
• Pneumococcal polysaccharide vaccine (PPSV23)
• Diabetes is a risk factor for invasive pneumococcal disease
Source: https://www.cdc.gov/pneumococcal/vaccination.html
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