Influenza Vaccination Guidelines for Type II Diabetes Patients

Recommendations Based on Age and Immunosuppression Status

The American Diabetes Association conditionally recommends high-dose or adjuvanted influenza vaccination for patients with Type II diabetes mellitus under age 65 who are taking immunosuppressive medications, while standard-dose influenza vaccine is appropriate for most Type II diabetes patients under age 65 who are not immunosuppressed 1, 2
High-dose quadrivalent inactivated influenza vaccine is recommended for patients with Type II diabetes aged 65 years and older due to additional benefits in this age group 1
The Centers for Disease Control and Prevention recommends preferential use of higher-dose or adjuvanted influenza vaccines for all adults aged 65 years and older 3
For patients with diabetes who are also taking immunosuppressive medications, high-dose or adjuvanted influenza vaccination is conditionally recommended over standard-dose 2

People with diabetes have higher rates of influenza-related complications, hospitalizations, and mortality compared to the general population 1
Influenza vaccination in people with diabetes significantly reduces influenza and diabetes-related hospital admissions 1
In people with diabetes and cardiovascular disease, influenza vaccine has been associated with lower risk of all-cause mortality, cardiovascular mortality, and cardiovascular events 1
Studies show that people with diabetes generally have appropriate humoral immune responses to vaccination 4, 5
Subgroup analyses of patients with diabetes support that vaccination against influenza has been effective in reducing hospital admissions during influenza epidemics 4, 5

Any influenza vaccine is preferred over no influenza vaccine, and vaccination "today" is preferred over delay 2
If high-dose or adjuvanted influenza vaccine is not available during a patient visit when influenza vaccination is indicated, standard-dose influenza vaccine should be administered 2
High-dose influenza vaccine is a quadrivalent vaccine containing 4 times the antigen as the standard-dose vaccine 2
The adjuvanted influenza vaccine is a standard-dose quadrivalent vaccine containing the MF59 adjuvant, which elicits a strong antigenic response 2

The influenza vaccine contains only noninfectious viruses and cannot cause influenza or other respiratory disease 5
The most common side effect is mild soreness at the vaccination site 5
Individuals with chicken egg allergy may experience immediate allergic reactions 5
Adjuvanted vaccines may be associated with greater reactogenicity, though no major safety issues have been identified 2
The vaccine should not be administered to individuals with anaphylactic hypersensitivity to chicken eggs or additional components of the influenza vaccine 5
It is recommended not to administer the influenza vaccine to individuals known to have developed Guillain-Barré syndrome within 6 weeks of a previous influenza vaccination 5