​Diabetes: Recommended Vaccinations for Children and Adults

Recommended routine vaccinations for children and adults with diabetes include:

1. Influenza vaccination
2. Pneumococcal vaccination
3. Hepatitis B vaccination

Annual influenza vaccinations are recommended for people with diabetes aged ≥ 6 months. Annual vaccinations are required because immunity declines 1 year after a previous vaccination.

The influenza vaccination is given as a single intramuscular injection. It provides protection against the 3 main strains of influenza which circulate during the flu season.

The pneumococcal vaccination is given as a single intramuscular injection. There are 2 types of pneumococcal vaccine available:

1. Pneumovax 23 (PPV23)
2. Prevenar 13 (PCV13)

These vaccines protect against many strains of pneumococcus which commonly cause disease.

When both vaccines are recommended, Prevenar 13 (PCV13) should be given first, followed by Pneumovax 23 (PPV23) at least a year later.

“This sequence helps to achieve the strongest immunity,” says Dr Bee Yong Mong, Head, SingHealth Duke-NUS Diabetes Centre, and Senior Consultant, Department of Endocrinology, Singapore General Hospital (SGH), a member of the SingHealth​ group.

Always inform your doctor about your previous vaccination history so they can decide on the best vaccination schedule for you.

Prevenar 13 (PCV13) is recommended for infants younger than 2 years old as a series of 4 doses, starting at 2 months of age.

Pneumovax 23 (PPV23) is not effective in infants younger than 2 years old, and it is not recommended.

Children with diabetes aged between 2 to 5 years who have not previously received PCV13 should receive 1 or 2 doses of PCV13.

Children with diabetes aged ≥2 years should also receive PPV23.

Pneumovax 23 (PPV23) is recommended for adults with diabetes aged <65 years. Adults aged ≥65 years should receive both Prevenar 13 (PCV13) and PPV23.

Adults who have previously been vaccinated against pneumococcus before age 65 should still receive PCV13 and a booster PPV23 vaccination after they turn 65.

The hepatitis B vaccine is given as 3 intramuscular injections over a period of 6 months (at 0, 1 and 6 months). It is recommended for all children and adolescents with diabetes.

It is also recommended for adults with diabetes who are younger than 60 years old. Hepatitis B vaccination may also be considered in adults above the age of 60, after discussion with a doctor.

If you have the following conditions, you may not be able to receive certain vaccines, or may need to take precautions when getting vaccinated.

Tell your doctor about these conditions when discussing suitable vaccinations:

1. Serious reactions to a previous dose of the vaccine
2. Serious reactions to certain antibiotics
3. ​Egg or yeast allergy
4. Conditions which predispose to bleeding (e.g. low platelet count, blood thinning medications)
5. Ongoing illness (vaccination may need to be postponed)

All vaccination recommendations are based on recommendations from the Centers for Disease Control and Prevention, Advisory Committee on Immunization Practices and American Diabetes Association.