Adult Vaccination: A Critical Element to a Life Course Approach to Healthy Ageing for Adults with Diabetes

Consensus Statement

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Diabetes is a significant global public health concern with wide ranging social and economic consequences.  In the United Kingdom close to 4 million people live with diabetes,[1] with associated costs expected to reach £16.9 billion by 2035.[2]

Older people with diabetes often deal with additional chronic conditions which together result in a weakened immune system, lowering their defenses against vaccine preventable diseases (VPDs) such as influenza,[3] pneumonia[4] and shingles.[5]

On 6-7 September 2018, the International Federation on Ageing (IFA) hosted the “Vaccinations and the At-risk Adult Population of Diabetes” expert meeting in Belfast, United Kingdom, in cooperation with Diabetes UK, the leading charity dedicated to people with diabetes in the United Kingdom.

The multidisciplinary meeting brought together experts in the fields of public health, diabetes, ageing, immunology and sociology from Diabetes UK, Public Health Agency Northern Ireland, Age NI, ILC-UK, Diabetes Frail Ltd., Dingwall Enterprises Ltd., Pfizer, London School of Hygiene and Tropical Medicine, Queen’s University Belfast and Imperial College London.

These key opinion leaders came together to build capacity and gather resources on the importance of adult vaccination for people with diabetes; share knowledge on successful educational programs and determine optimal ways to push the agenda forward.

A consensus was met on the following:

1. Vaccination is a critical element of a public health strategy to improve and maintain the health and function of older people with diabetes. Therefore, the primary goal of the meeting was to place adult vaccination as an important preventative approach on the agenda of diabetes organizations
2. Key barriers to improving uptake rates in this at-risk population are lack of awareness and misinformation surrounding the importance and availability of vaccines to adults with diabetes
3. Cross-sectoral collaboration is critical to raising vaccination on the agenda of diabetes organizations, in the form of joint campaigns, statements and conferences
4. Adding evidence-based information on the importance of vaccines for people with diabetes to diabetes self-management programs, diabetes management guidelines (i.e. European Diabetes Working Party for Older People) and diabetes conferences has the potential to play an important role in increasing the uptake rate of vaccination for people with diabetes

Using their collective capabilities and resources, this consensus statement represents delegates’ joint commitment to support cross-sectoral organizations to advocate and mobilize knowledge to their members on the importance of vaccination for adults with diabetes.

Consensus Stakeholders

• Jane Barratt                              International Federation on Ageing
• Megan Acton                            International Federation on Ageing
• Alan Sinclair                             Diabetes Frail Ltd.
• Diane Thomson                       Pfizer
• David Cavan                             Diabetologist and Author
• Albert Clyde                             Diabetes UK Support Group, Northern Ireland
• Tom Rush                                 Diabetes UK Support Group, Northern Ireland
• David Sinclair                          ILC-UK
• Robert Dingwall                      Dingwall Enterprises Ltd.
• Linda Robinson                      Age NI
• Peter Passmore                       Queen’s University Belfast
• Barbara Nicol                          Diabetes UK Support Group, Northern Ireland
• Colin Nicol                               Diabetes UK Support Group, Northern Ireland
• Jillian Patchett                        Diabetes UK, NI
• Alison Quinn                           HSC Public Health Agency, NI
• Daniel Howarth                      Diabetes UK
• Xiaoning Xu                            Imperial College London
• Punam Mangtani                   London School of Hygiene and Tropical Medicine
• Lindsay Prior                          Queen’s University Belfast
• Manjyot Singh Sandhar        Queen’s University Belfast

References

[1]  Diabetes UK, 2017. Diabetes prevalence 2017. Retrieved from https://www.diabetes.org.uk/professionals/position-statements-reports/statistics/diabetes-prevalence-2017

[2] Diabetes UK, 2012. NHS spending on diabetes ‘to reach £16.9 billion by 2035’. Retrieved from https://www.diabetes.org.uk/about_us/news_landing_page/nhs-spending-on-diabetes-to-reach-169-billion-by-2035

[3] Goeijenbier, M., Van Sloten, T. T., Slobbe, L., Mathieu, C., van Genderen, P., Beyer, W. E., & Osterhaus, A. D. (2017). Benefits of flu vaccination for persons with diabetes mellitus: a review. Vaccine, 35(38), 5095-5101.

[4] Garrouste-Orgeas, M., Azoulay, E., Ruckly, S., Schwebel, C., de Montmollin, E., Bedos, J. P., … & Dumenil, A. S. (2018). Diabetes was the only comorbid condition associated with mortality of invasive pneumococcal infection in ICU patients: a multicenter observational study from the Outcomerea research group. Infection, 1-9.

[5] Queenan, J. A., Farahani, P., Ehsani-Moghadam, B., & Birtwhistle, R. V. (2017). The prevalence and risk for herpes zoster infection in adult patients with diabetes mellitus in the Canadian Primary Care Sentinel Surveillance Network. Canadian journal of diabetes.