The updated 2018 ADA Standards of Medical Care in Diabetes Comprehensive Medical Evaluation and Assessment of Comorbidities not only includes continued, enhanced recognition of medication side-effect awareness and management but also emphasizes the critical importance of ensuring up-to-date vaccination status of patients with diabetes. In addition to the annual influenza vaccine, people with diabetes through age 64 years should also receive 23-valent pneumococcal polysaccharide vaccine (PPSV23), at an appropriately spaced interval, in addition to conjugate vaccine (Prevnar) PSV-13.

These immunization recommendations also include the critically important hepatitis B vaccine in addition to routinely scheduled vaccinations for adults with diabetes (and other specific age groups), including annual influenza and coordinated timing of pneumococcal pneumonia vaccine. People with diabetes are at higher risk for hepatitis B infection and are more likely to develop complications from influenza and pneumococcal disease. As a result, the CDC Advisory Committee on Immunization Practices (ACIP) recommends hepatitis B vaccinations, in additional to influenza and pneumococcal vaccinations, for people with diabetes. Individuals diagnosed with diabetes are more likely to be exposed to infected blood through improper use of equipment such as glucose-monitoring devices and/or infected needles.

According to the ADA, it is also important to remember that vaccination against tetanus-diphtheria-pertussis, measles-mumps-rubella, human papillomavirus, and shingles are also important for adults with diabetes. Roughly half of American adults have diabetes or prediabetes, according to the ADA, and every 21 seconds, another individual is diagnosed with diabetes in the U.S.