By Amy Campbell, MS, RD, LDN, CDE
Your doctor or diabetes educator may be on your case to get your flu shot every year (and rightly so). But there are a few others that you likely need, as well. More shots? Well, yes. Even if you feel fine, eat well and exercise regularly, the fact that you have diabetes puts you at greater risk of a number of illnesses compared with people who don’t have diabetes. Here are five recommended vaccines that you should at least consider getting.
The Centers for Disease Control and Prevention (CDC) recommends that everyone 6 months of age and older get a flu vaccine every year, especially those at high risk of getting complications from the flu that can be serious. Who is at high risk?
· Adults age 65 years and older
· Pregnant women
· Young children
· Children with neurological conditions
· People with asthma
· People with diabetes
· People with cancer
· People with HIV/AIDS
Influenza (aka, the flu) is a respiratory illness caused by influenza viruses. These viruses infect the nose, throat and, in some cases, the lungs. There are four types of flu virus: A, B, C and D. The A and B strains are the ones that infect people in the Unites States every winter and can cause epidemics.
There are different types of A and B strains, and every year, the flu vaccine is reformulated to attack those strains. This year, the vaccine is aimed at attacking four strains. If you’ve already had the flu this year, you might be thinking that you’re immune to getting the flu again, but that’s not true. Because there are different strains, you could get hit with a different flu virus again.
There is also no guarantee that getting a flu shot will protect you from getting the flu. You may get infected by a strain of flu virus that isn’t “covered” by the flu vaccine, and for some people, the flu vaccine doesn’t work that well. But the benefits outweigh the risks, especially if you fall into a high-risk category. If you get the flu, you generally feel pretty miserable for a couple of weeks. More serious complications can occur from the flu, including pneumonia, inflammation of the heart, brain or muscle, organ failure and sepsis.
Some people shouldn’t get a flu shot, including children younger than 6 months of age, people with an allergy to any ingredient in a flu shot, and possibly, people who have had a condition called Guillain-Barre Syndrome. Talk with your doctor if you’re concerned about getting the flu vaccine.
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Another vaccine to seriously consider getting is the pneumococcal vaccine. The CDC recommends that all children younger than 2 years of age and all adults 65 years of age or older get this vaccine; in addition, adults ages 19 through 64 should get the vaccine if they have chronic illnesses (including diabetes), HIV/AIDS, cancer or smoke cigarettes.
Pneumococcal disease is an infection that’s caused by pneumococcus bacteria. These bacteria can cause a number of infections, including pneumonia, meningitis, bacteremia (blood infection) and ear infections. Having diabetes puts you at an increased risk of death from pneumonia, bacteremia and meningitis. Pneumococcal disease is also infectious if you come in contact with mucus or saliva.
There are two types of pneumococcal vaccines: the PCV13 or Prevnar 13 and the PPSV23 or Pneumovax vaccines. The CDC recommends that people with diabetes get the Pneumovax vaccine — once as an adult before the age of 65 and then two more doses at 65 years or older. Those who shouldn’t get the vaccine include pregnant women and anyone allergic to the ingredients of the vaccine.
Hepatitis B is a contagious liver disease that results from an infection from the hepatitis B virus. This virus is spread by coming into contact with blood or other body fluids from an infected person, and can be spread by sharing needles, syringes or other injection equipment, as well as through sexual contact. Also, pregnant women with hepatitis B can infect their babies during childbirth.
People who have diabetes have higher rates of hepatitis B than people without diabetes. In some situations, people with diabetes have gotten infected by blood glucose meters or lancing devices used for more than one person (such as in a nursing home), using the same insulin syringe or pen for more than one person, or coming in contact with the virus through breaks in the skin.
In 2011, the CDC issued guidelines that recommend all unvaccinated adults under the age of 60 years of age get a hepatitis B vaccination. If you’re older than age 60, ask your doctor if you should get the vaccine. The hepatitis B vaccine is given as a serious of three shots over a period of 6 months. You must get the three shots to acquire long-term protection.
“Tdap” stands for tetanus, diphtheria and pertussis. These are serious diseases that are caused by bacteria. Tetanus (also called “lockjaw”) is rare, but it can kill one out of ten people who are infected. Symptoms include a painful tightening of muscles in the head and neck, preventing you from opening your mouth, swallowing and possibly breathing. Tetanus is acquired through cuts, scratches or wounds.
Diphtheria is an infection that affects the mucous membranes of the nose and throat, leading to sore throat, fever, swollen glands and weakness. A hallmark of this infection is a thick, grayish coating of the throat that can cause breathing problems, heart failure, paralysis and death. Diphtheria is contagious and spreads via secretions from coughing or sneezing.
Pertussis, or whooping cough, is highly contagious and causes a severe cough that makes a whooping noise. Coughing can be uncontrollable and can lead to vomiting, trouble sleeping and difficulty breathing, as well as weight loss, incontinence and rib fractures. Like diphtheria, pertussis is also contagious.
The Tdap vaccine is usually given to children at age 11 or 12. The CDC recommends that all adults get the Tdap vaccine once, and then a Td vaccine booster every ten years. However, talk with your doctor about getting the vaccine if you have seizures or other nervous system issues or have had Guillain Barre Syndrome.
The herpes zoster vaccine lowers the risk of developing shingles. Shingles is a viral infection that causes a very painful rash in adults. It’s caused by the same virus that causes chickenpox. If you’ve had chickenpox, the virus hides out in nerve tissue and down the road, it may cause shingles. Shingles is more common in people who have weakened immune systems.
Shingles isn’t life-threatening, but it can be extremely painful. It usually affects just one side of the body, often on the face or the torso. If the rash occurs near an eye, it can lead to vision loss. The virus can also cause encephalitis, facial paralysis and hearing problems.
Symptoms of shingles include:
· Pain, tingling or burning
· Fluid-filled blisters that scab over
Some people continue to have pain after the blisters and rash have disappeared. This is called postherpetic neuralgia (PHN), and it may persist for months or years.
There are two vaccines in the U.S. to prevent shingles: Zostavax and Shingrix. Zostavax has been used since 2006. It reduces the risk of getting shingles by 51% and PHN by 67%. It’s given as one shot. Zostavax is approved by the FDA for adults ages 50 years and older and it provides protection for about five years. Shingrix has been in use since 2017 for adults age 50 years and old and is preferred over Zostavax because it’s more than 90% effective at preventing both shingles and PHN. It’s given as two doses over the course of two to six months.
You can get the shingles vaccine even if you’d had shingles before. You just need to make sure that you don’t have the shingles rash before getting the vaccine. You shouldn’t get the Shingrix vaccine if you test negative for immunity to varicella zoster virus; if you do, you should get the chickenpox vaccine, instead.
Many people worry about side effects from vaccines. There’s always a risk of side effects, but for the most part, they’re relatively minor. Common side effects include:
· Soreness, redness or swelling at the injection site
· Mild fever or chills
· Feeling tired
· Muscle or joint pain
More serious side effects are pretty rare, but if they do occur, seek immediate medical assistance. Getting vaccinated from these harmful viruses and bacteria is much safer than getting the diseases that the vaccines prevent.
Want to learn more about protecting yourself against shingles and the flu? Read “Shingles Symptoms, Treatment and Prevention,” “Fight the Flu With Food” and “Planning Ahead for Sick Days With Diabetes.”
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