Immunizations for older adults with diabetes

Abstract

Diabetes mellitus is associated with impaired innate and adaptive immune responses, resulting in increased susceptibility to infections and a greater risk of severe disease, hospitalization, and mortality. Obesity, a common comorbidity in individuals with diabetes, further amplifies this risk through additional inflammatory and immunological mechanisms. In this context, vaccination is among the most cost-effective preventive interventions and has the potential to substantially improve health outcomes in older adults with diabetes. Beyond preventing infectious diseases, several vaccines have been shown to reduce the incidence of major adverse cardiovascular events, thereby decreasing hospitalization rates. Despite this evidence, vaccination coverage among adults remains suboptimal. This is driven by multiple factors, including misinformation, inaccurate risk perception, barriers to healthcare access, and, most importantly, the lack of timely recommendations from healthcare providers. Consequently, individuals with diabetes continue to face an unnecessarily high risk of vaccine-preventable infections and their associated complications.

In this presentation, we will discuss the major alterations in circulating immune cell populations identified by our research group in adults with diabetes, which may contribute to their increased susceptibility to infections. We will also review current immunization recommendations for older adults, examine the key barriers to vaccine uptake, and propose practical strategies to improve vaccination coverage. Routine assessment of vaccination status as an integral component of diabetes care represents an important opportunity to reduce the burden of infectious diseases, prevent cardiovascular complications, and ultimately improve both quality of life and life expectancy in people living with diabetes.