“Guidelines calling for influenza vaccinations in diabetic, in addition to elderly, adults implicitly single out working-age adults with diabetes. The evidence supporting such guidelines has hitherto been scant. We found that working-age adults with diabetes appear more susceptible to serious influenza-attributable illness. These findings represent the strongest available evidence for targeting diabetes as an indication for influenza vaccination, irrespective of age,” Darren Lau, PhD, of the department of public health sciences, School of Public Health, University of Alberta, Canada, and colleagues wrote.
Lau and colleagues looked at administrative data on patients with diabetes (n=56,513) who were matched 2:1 with controls (n=110,202) from July 1, 2000, to June 30, 2008. In total, they looked at 745,777 person-years of follow-up.
In this comparison, adults with diabetes had a 6% greater risk (RR=1.06; 95% CI, 1.02-1.1) increase in all-cause hospitalizations associated with influenza, totaling 54 additional hospitalizations. There were no differences in the influenza-attributable rates of influenza-like illness (P=.06) or pneumonia and influenza (P=.11).
“We infer that adults with diabetes experience a disproportionately greater susceptibility to more serious manifestations of influenza, requiring hospitalization,” the researchers wrote. “It may be cost-saving to target working-age adults with diabetes for vaccination, with a presumed rate of vaccine effectiveness as low as 20%. Of course, the unit cost of a diabetes-specific vaccination program may be much higher, and the actual effectiveness of influenza vaccinations in high-risk populations is not well established.”
According to researchers, this study was limited by the data, which represents only health care data, and may under-represent the total burden of influenza as much is unreported.