Flu Vaccination Opportunities Abound in Diabetics

Diabetics are at greater risk for viral and bacterial infection compared with the remainder of the population.

Diabetics are at greater risk for viral and bacterial infection compared with the remainder of the population.

For example, patients with diabetes contract acute hepatitis B twice as often as their non-diabetic counterparts. Diabetics are also more prone to complications, such as progression to pneumonia after a bout of the flu.

This increased susceptibility to infection is largely attributed to diabetics’ abnormal host defense mechanisms. Regardless, vaccination creates sufficient humoral immune response and antibody titers for most diabetics, decreasing their rates of pneumonia- and influenza-related morbidity and mortality.

In light of this, the Advisory Committee on Immunization Practices (ACIP) and the American Diabetes Association recommend that diabetics receive an annual influenza vaccination and at least 1 lifetime dose of the 23-valent pneumococcal polysaccharide vaccine (PPSV23).

A study published in the July 2015 issue of Clinical Diabetes Journal addressed adherence to such national guidelines for influenza, hepatitis B, and PPSV23 immunization in diabetic patients. These researchers retrospectively reviewed electronic medical records from Kent Hospital in Warwick, Rhode Island, and selected 100 patients for study inclusion.

The researchers determined patients’ immunization histories using nurses’ screening notes, intervention documentation, and prescription claims data. They found no absolute contraindications to vaccination.

Nevertheless, immunization rates failed to meet target figures set by the Healthy People 2020 initiative.

Of the 39% of patients identified as candidates for hepatitis B vaccination, none had initiated or completed the 3-dose vaccine series. Lack of provider awareness of the current ACIP recommendations may be at least partially to blame for the dismal rate of hepatitis B vaccination observed, the researchers hypothesized.

Adherence rates for pneumococcal and influenza vaccination were 37% and 41%, respectively.

Since pharmacists are authorized to administer vaccinations in all 50 states (with state-specific limitations), they can screen, educate, and immunize patients in a number of different health care settings.

Additionally, the Affordable Care Act now requires health plans created after September 23, 2010, to fully reimburse for ACIP-recommended vaccinations, thus removing an important financial barrier to immunization.