Curb vaccine-preventable diseases in diabetes patients

A variety of factors can impair the immunogenicity of the hepatitis B vaccine, including gluteal or intradermal administration, increased age, higher body mass index, and genetics, such as human leukocyte antigen-DR3, which is present in about 95% of people with type 1 diabetes. 

Unpublished data from the Centers for Disease Control and Prevention suggest that diabetes patients experience a similar drop in seroprotection with age (80% at 41-59 years, 65% at 60-69 years, and less than 40% at 70 years and older), he noted. 

For patients who fail to respond to the first or second series of vaccinations, based on postimmunization serologic testing, using a higher 40 mcg-dose or four doses at 0, 1, 2, and 6 months has been shown to improve immunologic responses. There is no need, however, to restart a series if it was interrupted, regardless of the duration between vaccinations, Dr. Parenti said. 

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