Vaccinations: The Shield Most People With Diabetes Never Use

Chapter 13 · Vihang Rahul Vasa

Which vaccines you need, and when, is a decision for your doctor, not one to take on your own. Some vaccines are not suitable for everyone, and the right timing depends on your age, your health, and your other conditions. What follows is what I learned and what I did, with my doctor’s guidance. I share it so that you know what to ask about. Vaccine advice changes every year, so what was true when this book was printed may have changed: your doctor will have the current guidance.

Let me clear the biggest doubt first, because I had it too: today, no vaccine prevents diabetes. Science may change that in the future; for now, it has not. The vaccines in this chapter are for people who already have diabetes, because diabetes quietly weakens the body’s defence against infections, and infections in turn hit us harder, hospitalise us more often, and can throw plasma glucose (blood sugar) out of control for weeks. It is a two-way street, and vaccination is how you close it. India’s own diabetes body, the Research Society for the Study of Diabetes in India (RSSDI), has published dedicated vaccination guidelines for people with diabetes (see Appendix A): yet vaccine uptake among Indian adults with diabetes remains very low, mostly because nobody tells us. Consider this chapter the telling.

The vaccines recommended for adults living with diabetes in India, as I understood them at the time of writing:

• Influenza (flu): every year, for everyone with diabetes. India sees two flu seasons (around March, and after the monsoon), so take it before the season begins. This is a yearly appointment, not a one-time shot.

• Pneumococcal (pneumonia): for everyone with diabetes. Good news: with the newer 20-valent conjugate vaccine (PCV20), a single shot is now usually all that is needed: the older two-dose schedules apply only where PCV20 is not available. Your doctor will confirm which is right for you.

• Hepatitis B: if you were never vaccinated. Recommended especially below 60 (after 60, your doctor decides). People with diabetes face frequent blood tests, injections, and small wounds: this vaccine guards that doorway.

• Tetanus group (Tdap/Td): once as Tdap, then a booster every 10 years.

• Shingles (Herpes Zoster): from age 50, in discussion with your doctor. Note: “shingles vaccine” and “herpes zoster vaccine” are the same vaccine: two names, one shield. Diabetes raises the risk of shingles, a painful rash whose nerve pain can linger for months.

• Chickenpox (Varicella): only if you have never had chickenpox and never been vaccinated against it. Adult chickenpox is far harsher than the childhood version, and harder still with diabetes: your doctor can check your immunity and advise the two-dose course if needed.

• Typhoid (Conjugate Vaccine): helpful though optional. A single-dose vaccine relevant in India, where typhoid remains common: worth discussing with your doctor, especially if you eat out often or travel within the country.

• Respiratory Syncytial Virus (RSV): a newer, less essential option for age 60 and above. It protects older adults from a winter lung virus, and your doctor may mention it as availability grows in India: the vaccines above come first.

• COVID-19, as per current government guidance.

• And TB?, There is no adult tuberculosis (TB) vaccine today, the BCG (Bacillus Calmette–Guérin) most Indians received at birth is a childhood vaccine, and new adult TB vaccines are still being developed and tested. For TB, your shield remains the symptom vigilance described earlier in this book.

Now the rules of this chapter, and they are absolute. A vaccine is a medical treatment, not a pharmacy purchase. Every vaccine must first be discussed with your treating doctor, taken only on their advice and written prescription, and administered in a hospital setting rather than an ordinary clinic, and after any vaccine, of any type, remain at the hospital for at least one hour of observation for any allergic reaction before leaving. Serious reactions are rare, but they announce themselves early, and the safest place to hear that announcement is where help stands ready. This applies to every vaccine on this list, every time.

One more honest sentence: I believe vaccines are going to matter more with every passing year: new ones are arriving faster than at any time in history. Ask your doctor once a year, at any routine visit: “Is my vaccination list up to date?” One question that may save you a hospital admission.

(Reference for this chapter: Research Society for the Study of Diabetes in India (RSSDI), Vaccination Guidelines for People with Diabetes, 2024: www.rssdi.in; Ministry of Health & Family Welfare, Government of India: www.mohfw.gov.in. Full citation in the Appendix.)

Illustration: Chapter 13 illustrated summary. Doctor-selected vaccines and timing, a written prescription, hospital vaccination and observation afterwards illustrate protection against infections.

Chapter 13 Doctor-selected vaccines and timing, a written prescription, hospital vaccination and observation afterwards illustrate protection against infections. No vaccine prevents diabetes.

Chapter at a glance: an AI-generated illustration to be read with the chapter, not instead of it. The people shown are not real.