Why Hepatitis B vaccine highly recommended for those with diabetes

Hepatitis B Vaccine Recommended for Diabetics

As you’re probably aware, more and more Americans are being diagnosed with diabetes. The reasons include more obesity, less physical exercise, and genetics.

You’re probably also aware of hepatitis B, a potentially serious and sometimes fatal infection of the liver caused by hepatitis B virus. We don’t usually think of diabetes and hepatitis as being related, but there is an increased risk of becoming infected with hepatitis B if you’re a diabetic. The risk is present whether one has type 1 or type 2 diabetes.

Since the early 1990s newborns and infants in the United States have routinely been vaccinated against hepatitis B, so most children and teenagers in the U.S. are now protected against this infection. Most adults are not.

This past fall the influential ACIP (Advisory Committee on Immunization Practices) recommended that all previously unvaccinated adult diabetics from 19 through 59 years of age be vaccinated with the hepatitis B vaccine “as soon as possible after a diagnosis of diabetes is made.” The recommendation was given an “A” category rating, its highest endorsement, based on the strength of the data. In late December 2011 the CDC (Centers for Disease Control and Prevention) published this recommendation in its weekly report.

For those who like figures, here are the benefits according to the CDC if 10% of unvaccinated adult diabetics in the U.S. got vaccinated against hepatitis B: 4271 fewer hepatitis B infections, 467 fewer hospitalizations, 33 cases of liver cancer prevented, 13 liver transplants avoided, and 130 fewer deaths. And that’s if only 10% of those eligible got vaccinated.

For diabetics 60 and older, the evidence supporting vaccination isn’t as strong. Part of the reason has to do with immune response in seniors. The younger one is when vaccinated, the better the vaccine works. (I wouldn’t be surprised if that recommendation were to change to a full endorsement of hepatitis B vaccination for seniors with diabetes in the not-too-distant future.)

For now, the vaccine is strongly “recommended” for adult diabetics 19-59 which means that your health insurance will likely cover its cost for you if you’re in this category. Millions of American adults are.

Brad Gascoigne, M.D.
Smart Readers Health Column