National Foundation for Infectious Diseases Urges Increased Influenza Vaccination Rates for Persons with Diabetes


BETHESDA, Md. -- The National Foundation for Infectious Diseases (NFID) is calling for the medical and public health community to increase alarmingly low influenza vaccination rates among persons with diabetes -- the fifth deadliest disease in the U.S. Influenza is a serious respiratory illness that can lead to severe complications in people with diabetes, including increased risk of high or low blood sugar, as well as diabetic coma. Yet, more than ten million Americans with diabetes lack the protection afforded by a single annual influenza vaccination.

"Complications from influenza can be serious and even fatal to those with diabetes," said NFID vice president William Schaffner, MD. "Many health care professionals come in contact with these high-risk patients and all can play a role in increasing influenza vaccination rates."

The Centers for Disease Control and Prevention (CDC), American Diabetes Association (ADA) and other leading medical groups recommend an annual influenza vaccination for anyone six months of age and older with diabetes, as well as their close contacts (including health care workers and household members). However, less than half of all persons with diabetes are immunized each season.

Today Schaffner presented, "Improving Influenza Vaccination Rates in Adults and Children with Diabetes: Identifying and Overcoming Immunization Barriers in this High-risk Population," to members of the CDC's Advisory Committee on Immunization Practices. The report outlines useful tactics and interventions that can be applied within various clinical settings that treat patients with diabetes. NFID's Call to Action marks the beginning of a new initiative targeting improved influenza vaccination efforts for persons with diabetes, which is supported by more than 15 of the nation's key medical and public health organizations that all play a key role in treating this at-risk population.

Strategies and Tools to Prevent Influenza in Persons with Diabetes

The report highlights various approaches for practices and institutions that provide influenza vaccine, as well as for those that do not provide vaccine services yet can refer patients to be immunized elsewhere.

-- Increase influenza vaccine access and demand (e.g., influenza vaccine-only clinics, extended office hours, consumer education)

-- Overcome practice-related barriers (e.g., update standing orders, addition of influenza vaccination to quality care checklists)

-- Recommend influenza vaccination through various channels (e.g., posters, postcards, emails) as well as the entire office, including non-medical staff members

"Professional organizations that provide optimal care for persons with diabetes also play a key role in this effort," said NFID medical director Susan J. Rehm, MD. "These groups should add annual influenza vaccination to their quality assurance check lists, which will help insure their members offer adults and children with diabetes complete care according to longstanding national recommendations."

Influenza is a serious and potentially deadly respiratory infection that spreads from person to person and infects up to 60 million Americans annually.

The virus is responsible for more than 200,000 hospitalizations and an average of 36,000 deaths each year. Diabetes has a prevalence of about seven percent, resulting in nearly 21 million Americans with diabetes. One-third of these individuals are unaware of their condition.

Americans with diabetes may have impaired immune function that can lead to increased morbidity and mortality from influenza infection. Influenza may also interfere with blood glucose management, putting those with diabetes at increased risk of high glucose levels and those with type 1 diabetes, in particular, at an increased risk of diabetic coma.

Influenza vaccination is safe and effective in persons with diabetes. 

Studies have found more than 70 percent reduction in hospitalizations and death among adults with diabetes receiving an influenza vaccination. In addition, research has shown influenza vaccination associated with nearly 80 percent decrease in hospital admissions among children and adults with diabetes.

NFID's Improving Influenza Vaccination Rates in Adults and Children with Diabetes initiative is designed to highlight the severe complications influenza infection can cause in this at-risk group with this prevalent chronic medical condition, as well as reinforce the importance of vaccinating anyone with diabetes and their close contacts each year. Organizations that support the goals of NFID's initiative include the American Academy of Family Physicians, American Academy of Pediatrics, American Academy of Physician Assistants, American Association of Diabetes Educators, American College of Physicians, American Diabetes Association, American Medical Association, American Nurses Association, American Pharmacists Association, Asian Pacific Islander American Health Forum, Cincinnati Children's Hospital, Kaiser Permanente of Northern California, National Association of Pediatric Nurse Practitioners, National Diabetes Education Program, National Medical Association, Society for Adolescent Medicine and Visiting Nurse Associations of America.

NFID developed the new Call to Action report from proceedings of a roundtable meeting held last November in Washington, D.C. Representatives from these organizations agreed that improving immunization rates is an important goal for reducing morbidity and mortality in people with diabetes.

In addition to this report, which is online at the NFID Web site,, NFID plans to develop and issue a more comprehensive monograph that will outline key strategies to serve as national models for improving immunization rates in people with diabetes.

Source: National Foundation for Infectious Diseases

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