Vaccination Coverage Among Adults With Diagnosed Diabetes: United States, 2015

Questions for Maria A. Villarroel, Ph.D., Health Statistician and Lead Author on “Vaccination Coverage Among Adults With Diagnosed Diabetes: United States, 2015.”

Q: Why did you decide to look at vaccination coverage with diagnosed diabetes?

MV: Persons with diabetes are at an increased risk for complications from vaccine-preventable infections, and a number of these of vaccines are recommended for adults living with diabetes. We wanted to examine the vaccine coverage among different segments of adults with diagnosed diabetes. This report describes the receipt of select vaccinations among adults with diagnosed diabetes by sex, age, race and ethnicity, and poverty status.

Q: Overall, which vaccinations were more prevalent for adults with diagnosed diabetes?

MV: We examined vaccination coverage for influenza, pneumococcal, hepatitis B and shingles among adults with diagnosed diabetes. Among adults aged 18 and over with diagnosed diabetes, influenza vaccination (61.6%) was more prevalent than pneumococcal (52.6%) and hepatitis B (17.1%) vaccination. The shingles vaccine is indicated for those aged 60 and older and we found that fewer than 3 in 10 (27.2%) adults aged 60 and over with diagnosed diabetes had been vaccinated for shingles.

Q: How did the vaccination rates for adults with diagnosed diabetes vary by age?

MV: We compared vaccination coverage for influenza, pneumococcal and hepatitis B among adults diagnosed with diabetes who were aged 18-44, 45-59, 60-74 and 75 and over. Vaccination coverage was not the same across age groups. Vaccination for influenza and pneumococcal disease increased with age. In contrast, vaccination for Hepatitis B decreased with age. We also examined vaccination coverage for shingles among adults aged 60 and over, and those who were aged 75 and over were likely to have been vaccinated than those aged 60-74.

Q: How did the vaccination rates for adults with diagnosed diabetes vary by race and ethnicity?

MV: We compared vaccination coverage among adults with diagnosed diabetes who were Hispanic, Non-Hispanic white, non-Hispanic black and Non-Hispanic Asian. Non-Hispanic white adults were more likely than non-Hispanic black and Hispanic adults to have been vaccinated for influenza in the past year and to have ever been vaccinated for pneumococcal disease and shingles at some point in the past. Non-Hispanic Asian adults were more likely than non-Hispanic black and Hispanic adults to have been vaccinated for influenza, but these groups did not differ from one another on pneumococcal and shingles vaccination.

Q: Were there any findings that surprised you?

MV: It was surprising to see the difference in the vaccination coverage for vaccines that are recommended for all adults with diabetes. In addition to differences by age and race and ethnicity, we observed wide differences in vaccination coverage by income status. Adults with diagnosed diabetes who were not living in poverty were consistently the most likely group to have been vaccinated for influenza, pneumococcal disease, hepatitis B, and shingles. From other reports, diagnosed diabetes is more common among poor and near poor adults, yet this report showed that these group are the least likely to get vaccinated.