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Canadian Pharmacists Association
Canadian Pharmacists Association
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Chapter 19: Influenza and Pneumococcal Immunization

Canadian Diabetes Association 2013 Clinical Practice Guidelines for the Prevention and Management of Diabetes in Canada

Introduction
  • Patients with diabetes are at a greater risk for hospitalization, morbidity and mortality arising from influenza and pneumococcal disease.
  • Influenza immunization is associated with up to a 40% risk reduction in mortality.
    • Clinical recommendations for vaccination are derived from large cohort studies that included people with diabetes. Trials specific to individuals with diabetes are currently lacking.
Influenza Immunization in Adults
  • A recent epidemiological analysis of pandemic influenza demonstrated that people with diabetes are more likely to be hospitalized or to require intensive care.
  • Over a period of 10 influenza seasons, influenza vaccination was shown to be effective in reducing both death and hospitalization from influenza and pneumonia in a cohort that included people with diabetes.
  • People with diabetes should receive an annual influenza immunization to reduce the risk of complications associated with influenza [Grade D, Consensus].
Pneumococcal Immunization in Adults
  • People with diabetes are at increased risk of hospitalization for pneumococcal disease.
  • Prior pneumococcal vaccination is associated with a reduction in death and complications in hospitalized adults with community-acquired pneumonia.
  • Pneumococcal immunization should be offered to people with diabetes. A single dose is recommended for those >18 years of age. A 1-time revaccination is recommended for those >65 years of age (if the original vaccine was given when they were <65 years of age) with at least 5 years between administrations [Grade D, Consensus].

For definitions of the levels of evidence cited in this chapter, please refer to the Guideline Recommendations: Levels of Evidence.

If you would like more details on this topic, please visit the Canadian Diabetes Association Clinical Practice Guidelines: Chapter 19.