Recommendations

What Are the National and Global Recommendations for Pneumococcal Vaccination in Diabetics?

Patient assessment of the burden of disease due to vaccine-preventable disorders clearly shows that pneumococcal disease is the leading cause of death in all age groups, with the elderly population being the most affected. The high CFRs of bacteraemic pneumococcal diseases demand effective preventive strategies, including immunoprophylactic measures and vaccines. However, in diabetic populations, such strategies may be challenging due to the presence of immune abnormalities. The antibody response of diabetics, especially in high-risk groups, needs to be studied with various vaccination strategies. Recommendations for vaccinations are based on the main risk factors for infectious diseases such as age, the presence of chronic diseases, immunosuppression, smoking status, alcohol use and ethnic groups which include diabetes. The organisations that have issued guidelines for pneumococcal vaccination in diabetes include the ACIP, ATAGI,the Canadian National Advisory Committee on Immunization and the United Kingdom Department of Health, among several others.^1-4
 

Various national guidelines, like the Geriatric Society of India (2015) and RSSDI (2020), recommend vaccination in diabetic patients to prevent pneumococcal diseases.^5,6
The RSSDI guidelines state that⁶:
PCV13 is recommended for adults aged ≥50 years followed by a dose of PPSV23 at least 1 year later, (and at least 5 years after their previous PPSV23 dose) depending on the clinical judgment of the physician.

• PCV13 must be considered as an important step for vaccinating older diabetic patients who are aged >50 years
• PPSV23 may be offered to immunocompromised patients with diabetes for additional coverage after PCV13
• Repeated vaccination with PPSV23 must be avoided to prevent hyporesponsiveness