A vaccine can be given in many ways. It can be injected into muscle (intramuscular), into fat (subcutaneous), or just under the skin (intradermal). Vaccines can also be given through a nasal spray, or by mouth as an oral capsule. Each vaccine should be given in a specific way, depending on the product.
Although many vaccine-preventable diseases may seem to have disappeared, protect yourself by staying up-to-date with recommended immunizations. Outbreaks of disease can happen at any time among those who are not protected.
For a number of reasons, people with diabetes should be especially careful to keep their immunizations up-to-date. Their immune systems may be weak compared to those without diabetes. If so, they are at greater risk of sickness or death because of an uncontrolled infection. People with diabetes also tend to have a higher risk of developing kidney and heart problems. This means they are more likely to be hospitalized or even die from illnesses like influenza and pneumococcal disease, compared to the average person.
A number of different vaccines are recommended for people with diabetes. In general, all routine childhood immunizations should be up-to-date. This maintains a baseline protection. In addition, the usual routine immunizations for adults are recommended. This includes a tetanus and diphtheria (Td) booster every 10 years, with a single dose given as Tdap (tetanus, diphtheria, and acellular pertussis) if not previously given in adulthood. Up-to-date vaccinations against measles, mumps, rubella, and varicella (chicken pox) are also recommended. Two particularly important vaccines are the influenza and pneumococcal polysaccharide vaccine.
The influenza (flu) vaccine is changed each year. As a result, immunization is needed every year to protect against different types of flu viruses. Flu activity is monitored constantly throughout the world. Each year, predictions are made about which virus strains are most likely to affect Canadians. Based on global data, three likely strains are chosen for the yearly flu vaccine. This means that each year, the flu vaccine protects you against different types of flu.
Pneumococcal disease can cause very harmful infections for those at risk, including people with diabetes. This includes infections of the lungs (pneumonia), of the brain and spinal cord coverings (meningitis), and of the blood (sepsis). A pneumococcal vaccine is suggested for anyone over age five who is at risk (such as people who have diabetes), and for everyone over age 65. Some very high-risk individuals may require more than one dose, but most people only need one.
Shingles is a disease caused by the same virus which causes chickenpox in the body. When someone gets chickenpox, even after the sickness is over, the virus stays in the body. Normally the immune system keeps this virus under control. However, with increasing age or illness, the immune system can become weak and the virus can reactivate. This reactivation is known as shingles. Shingles can lead to a severe painful rash, along with nerve pain as a potential long-lasting complication. In some cases this nerve pain can last well beyond the actual case of shingles, and in some cases, even last a lifetime. As people with diabetes typically have a weaker immune system, they are a higher risk of developing shingles as they become older. A shingles vaccine known as Zostavax is available. This is a one-time vaccine for individuals over the age of 50. It can help reduce the risk of developing shingles as well as the associated nerve pain. This vaccine is more effective the sooner it is given so, to maximize your protection against shingles, get it sooner rather than later.
Some people have mistaken ideas about vaccinations, which cause concern. For instance, some worry that the flu vaccine will give them the flu and think they get sick from it. However, this is actually not possible. Any injectable flu vaccine available in Canada is an inactivated vaccine. It is made from only a portion. of a flu virus, such as a surface protein. Picture a flu virus as a bad guy wearing a red hat. Normally, this bad guy can move about, copy himself and do all sorts of things because he is alive. A flu vaccine is like taking the red hat off the bad guy, and making many copies of just that red hat. A vaccine made from these red hats cannot hurt you because it is not alive. It cannot do anything. However, your body still recognizes the pile of red hats as something foreign, and creates antibodies against it. What’s more, the body remembers this red hat as an intruder. If this flu virus (the bad guy with the red hat) tries to infect your body again, it is immediately recognized. Your body sounds the alarm, destroying the intruder before it can make you sick.
Some flu vaccines given as a nose spray are live flu vaccines. However, even these vaccines cannot make you sick. Normally, a flu virus has to copy itself inside your lungs to make you sick. However, this live nose spray vaccine is made from a cold-adapted virus. It can only copy itself within your nose, which will not make you sick.
Why then do some people get sick after receiving a flu vaccine? It may simply be because they came into contact with a virus that was not among the three strains chosen for the flu shot that year. As well, it takes up to two weeks for the flu shot to protect against the flu. If you encounter a flu virus during that time, you can still get sick.
Some people are concerned that vaccines may overload or weaken their immune system. However, this is not the case. The immune system can recognize hundreds of thousands, if not millions, of different organisms. Every day, we encounter many different organisms through normal eating, drinking and playing. Vaccines for certain diseases use only a very small part of the immune system’s memory. These vaccines help strengthen the immune system and protect against severe illnesses like tetanus, diphtheria, pertussis, meningitis, and pneumonia.
Vaccines have significantly improved health over the past century. They protect many high-risk people, including those with diabetes, from severe illness. The benefits greatly outweigh the risks.
If you have diabetes, keeping your immunizations up-to-date is very important. It is a good idea to maintain an adult immunization record, and update it every time you receive any vaccine. This advises health care providers of the vaccines you have or haven’t received, so they can give you the best possible care.