Vaccinating Against Hepatitis B in Adults With Diabetes

Since 1996, 29 outbreaks of hepatitis B virus (HBV) infection in long-term care facilities have been reported to the CDC, 25 of which involved adults with diabetes who were receiving assisted blood glucose monitoring. As a result of these reports, the Hepatitis Vaccines Work Group of the Advisory Committee on Immunization Practices (ACIP) created recommendations for hepatitis B vaccination for adults with diabetes that were published in Morbidity and Mortality Weekly Report. Significant Findings & Recommendations According to our investigation, people aged 23 to 59 who had diabetes had 2.1 times the risk of developing acute HBV when compared with those without diabetes. For those aged 60 or older, patients with diabetes were 1.5 times more likely to acquire HBV than those without the disease. The annual incidence of reported acute HBV infection among adults with diabetes is 1.8 per 100,000. It’s believed that an additional 10.5 new cases of HBV infection occur for each reported confirmed case. Data from 2009-2010 Emerging Infections Program sites indicated that the case-fatality rate among HBV-infected people with diagnosed diabetes was 5%, compared with 2% for people without diabetes. On the basis of available information (including information about HBV risk, morbidity and mortality, and cost-effectiveness), the ACIP recommended the following: 1) Unvaccinated adults with diabetes aged 19 to 59 should receive the hepatitis B vaccine. 2) At the discretion of clinicians, the hepatitis B vaccine may be administered to unvaccinated adults with diabetes aged 60 and older. The ACIP recommendation for adults aged 60 and older is not as strong as the recommendation for adults aged 19 to 59 because the estimated cost...