Evaluation of Influenza, Pneumococcus, Zoster, Measles, Diphtheria, and Pertussis Vaccination Rates in Patients with Type 1 and Type 2 Diabetes Mellitus; a Single-Center Experience From Turkey

Objective: Several vaccines have been recommended for adults with diabetes. This study aimed to determine the rates of uptake of recommended vaccines in diabetic adults and estimate their association with sociodemographic and clinical factors. Material and Methods: This was a cross-sectional study conducted on patients with either type 1 or type 2 diabetes, who had attended the outpatient clinics of internal medicine and endocrinology. The patients were inquired about their immunization status against influenza, pneumococcus, zoster, measles, pertussis, and diphtheria. Results: Among the 350 diabetic patients, 38 (10.8%) had received a vaccine against pneumococcus, 90 (26%) against seasonal influenza, and only one patient had been administered the zoster vaccine. None of the patients had been vaccinated against measles, diphtheria, and pertussis. The rate of pneumococcal vaccination (PV) increased with age (65.5±9.7 vs. 57±9.1 [OR 2.9 (95% CI=14.32.67], p=0.005), although there was no such association between influenza vaccination (IV) and age (p=0.456). The rate of PV increased with the number of routine follow-up visits per year (10/38 vs. 28/38 [OR 4 (95% CI=0.994-16.096], (p=0.039). The rates of PV and IV were significantly higher in diabetic patients with chronic pulmonary disease (21/38 vs. 14/312 [OR 52.80 (95% CI 8.4333.1], p=0.005 and 31/90 vs. 4/260 [OR 29.15 (95% CI 3.37252.28], p=0.001) respectively. The rates of IV in diabetic patients with chronic renal failure were also significantly different from those without (27/90 vs. 8/260, [OR 14.28 95% CI 1.51-133.74], p=0.013). Conclusion: We observed low rates of vaccination against influenza, pneumococcus, and zoster in patients with diabetes, which were below the targets recommended by the World Health Organization.