Academic journal article Central European Journal of Public Health

Vaccination of Patients with Diabetes Mellitus - a Retrospective Study

Academic journal article Central European Journal of Public Health

Vaccination of Patients with Diabetes Mellitus - a Retrospective Study

Article excerpt

SUMMARY

402 subjects with diabetes mellitus have been vaccinated of the total of 34,000 vaccinees immunized during the study period of 9 and half months. Altogether 229 diabetic patients (56.97%) have been vaccinated against tick-borne encephalitis (TBE) and 74 (18.4%) against viral hepatitis (41 types A+B, 30 type A, 3 type B). The average age in four most commonly administered vaccines (FSME IMMUN 0.5 ML, Twinrix Adult, Typhim Vi, and Havrix 1440) was 65, 52, 56, and 54 years, respectively. Live attenuated vaccines have been given to 6 patients with diabetes (1.49%) - 5 travellers to endemic countries received the yellow fever vaccine Stamaril (1 female, 4 male) and one male patient varicella vaccine Varilrix. Among the least common vaccines in diabetic patients were those against invasive pneumococcal and meningococcal infections. Not a single unexpected side effect has been observed following the vaccination procedure in any diabetic patient.

Based on the results of this retrospective study we can conclude that vaccination in diabetic patients is free of any risk - provided that there are no other contraindications, e.g. allergy to vaccine components or severe acute febrile illness. In the case of unstable glycaemia and significantly impaired immune system due to diabetes mellitus, vaccination with live attenuated vaccines should be carefully considered and measured against the risks of exposure to each and every specific infectious agent.

There is no reason to be afraid of vaccination in diabetic patients provided that general contraindications are respected. On the contrary, this risk group can benefit from vaccination more remarkably since it may have some life-saving potential.

Key words: diabetes mellitus, vaccination, killed vaccines, live attenuated vaccines, contraindications, side-effects, safety, primary care, vaccination rate, prevention

INTRODUCTION

Vaccination is ranked between the greatest achievements in human history and in the medical world. Names like Jenner, Pasteur, Calmette, Salk, Sabin, Behring etc. are known to wide public. Thanks to them, humankind has managed to eradicate the deadly and mutilating smallpox and paralysing poliomyelitis is nowadays present only in a few developing countries. Fatal neonatal tetanus is becoming rare even in African countries and the incidence of fearful measles is steeply declining (1-6).

Whilst vaccination coverage of the paediatric population in the Czech Republic is one of the highest in the world reaching up to 99 per cent, utilising vaccines guaranteed by the government and provided free of charge, a different picture of the vaccination take up in the adult population is often seen to be a long way behind other developed EU countries. Some vaccines and their producers have to face fake allegations about their serious side effects or contagiousness. These are literally handed-down from generation to generation without any scientific evidence. Despite the fact that vaccination experts argue against these myths, many laymen tend to believe them and spread the false stories further. However, what is even more startling is that these fabrications sometimes find their breeding grounds among primary care physicians. They are flooded with many novelties of the medical world from different specialities and often fail to recognise those that are of an important origin, scientific value and significance. Many primary care physicians for adults only vaccinate their patients against tetanus and a few patients against influenza and are simultaneously ignoring a wide range of other vaccines with life saving as well as cost saving potential. Some GPs, for example, refuse to vaccinate against flu from January onwards or against tick-borne encephalitis in the summer months, which is in both cases medically unjustifiable. Many are also not willing to offer vaccination to individuals with chronic long-lasting health problems, even if there are no real contraindications. …

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